Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen kɛse nka bere a oduruyɛfo no ka kyerɛ wo sɛ wo koma ayɛ mmerɛw, anaasɛ sɛnea yɛfrɛ no no, wowɔ komayare tebea bi. Wunim sɛnea ɛyɛ den sɛ wobɛtra ase wɔ ɔhaw ahorow te sɛ ɔbrɛ, nan a ahonhon, ne sɛ wuntumi nna yiye anadwo wɔ mmɔden kakra mpo akyi. Ɛtɔ mmere bi a, nsunsuanso bɔne te sɛ ɔfe a ɛka nnuru dedaw a wɔde ma tebea yi bi ho no betumi ayɛ abasamtu kɛse mpo. Nanso, esiane sɛ aduruyɛ ho nyansahu anya nkɔso nti, mprempren ayaresa ahorow a edi mu yiye na ɛyɛ foforo ada adi ama tebea horow a ɛtete saa. Nnuru foforo a ɛte saa no biako a ama nnipa pii ahotɔ ne ARNI. Momma yɛnka eyi ho asɛm nnɛ ara kwa.
Sɛ yɛbɛka no tiawa a, dɛn ne ARNI?
Bere a ebia edin ARNI no bɛyɛ te sɛ nea ɛyɛ den kakra no, nea ɛkyerɛ no yɛ mmerɛw koraa. ARNI (Angiotensin Receptor/Neprilysin Inhibitor) yɛ aduru titiriw bi a wɔde nnuru ahorow abien a wɔde ka bom de sa komayare so na ɛyɛ . Te sɛ agumadifo baanu a wɔn ho akokwaw a wɔbom di agoru wɔ kuw biako mu no, saa nnuru abien yi bom yɛ adwuma ma wo koma nya ahotɔ kɛse.
Nnuru abien yi ne:
1. ARB (Angiotensin II Receptor Blocker): Eyi din ne Valsartan.
2. Neprilysin Inhibitor: Eyi din de Sacubitril.
Mprempren, ARNI aduru biako pɛ a wɔde di dwuma wɔ Sri Lanka ne wiase nyinaa ne Sacubitril/Valsartan . Wɔpenee eyi so wɔ afe 2015 mu.
Okay, afei momma yɛnhwɛ sɛnea saa aduru yi yɛ adwuma wɔ nipadua no mu?
Sɛ yɛbɛte eyi ase a, momma yɛmfa nhwɛso tiawa bi nni dwuma. Fa no sɛ mogya a ɛkɔ wo nipadua mu no te sɛ paipu nhyehyɛe bi a ɛde nsu kɔ turo mu. Wo koma ne motor a ɛma nsu no fa mu.
1. Nea Valsartan yɛ: Wɔ komayare mu no, mogya ntini (ntini) yi mu yɛ den na esiw. Afei ɛsɛ sɛ koma no yɛ adwumaden paa na ɛde nhyɛso kɛse bɔ mogya (ntini) mu. Valsartan yɛ adwuma denam mogya ntini a ayɛ mmerɛw no a ɛtrɛw na ɛma ɛyɛ mmerɛw so . Afei koma no betumi de mogya akɔ nipadua no nyinaa mu ntɛm a ɛho nhia sɛ ɛyɛ adwumaden saa. Eyi nso hwɛ wo mogya so.
2. Nea Sacubitril yɛ: Eyi yɛ soronko kakra. Yɛn nipadua fi awosu mu yɛ "hormone pa" a ɛboa koma no, ɛtrɛw mogya ntini mu, na ɛboa nipadua no ma nkyene ne nsu a ɛboro so fi hɔ. Nanso, enzyme bi a wɔfrɛ no "Neprilysin" (te sɛ onipa bɔne) sɛe ntɛmntɛm na ɛsɛe saa hormone pa yi. Nea Sacubitril yɛ ne sɛ esiw onipa bɔne, neprilysin enzyme no kwan sɛ ɔnyɛ adwuma . Afei saa hormone pa no betumi atra nipadua no mu akyɛ na ayɛ wɔn adwuma pa (mogya mmoroso a ɛba fam, yi nkyene ne nsu fi mu).
Sɛ yɛbɛka no tiawa a, nnuru abien yi bom yɛ adwuma ma adesoa a ɛda koma no so no so tew, bere a ɛbɔ abɔde mu nkwaadɔm a ɛboa koma no ho ban no.
Henanom na wɔkamfo ARNI aduru yi kyerɛ wɔn?
Mpɛn pii no, wo duruyɛfo begyina nneɛma pii so asi gyinae sɛ saa aduru yi fata wo anaa.
- Wɔ nnipa a wɔwɔ komayare fam: Ebia wobefi ase anom saa aduru yi sɛ wɔahu sɛ woanya komayare foforo na wo koma no mogya a ɛbɔ yiye (yɛfrɛ eyi Ejection Fraction ) yɛ 40% anaa nea ennu saa a. (Saa botae yi ma onipa a ɔwɔ apɔwmuden a ɛteɛ no bɛyɛ 55% - 65%).
- Wɔn a wɔresakra afi nnuru dedaw so no: Sɛ worenom nnuru a wɔde siw komayare ano te sɛ ACE inhibitor (e.g. Enalapril, Ramipril) anaa ARB (e.g. Losartan, Telmisartan) dedaw a, ebia wubetumi adan akɔ ARNI so mmom.
Ɛho hia paa!
Sɛ woresakra afi ACE inhibitor (e.g. Enalapril) so akɔ ARNI so a, anyɛ yiye koraa no ɛsɛ sɛ wotwɛn nnɔnhwerew 36 wɔ bere a woagyae ACE inhibitor no akyi ansa na woafi ARNI ase. Sɛ wosakra nnuru abien no mu a bere ntwa mu yi a, ebia wubenya akisikuru a ɛyɛ hu a wɔfrɛ no angioedema , a ɛma w’anim ne wo menewa hohoro. Enti, ɛho hia paa sɛ wudi wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ.
| Hena na ɛnsɛ sɛ ɔnom ARNI? | Nkyerɛmu |
|---|---|
| Nnipa a na wɔadi kan anya akisikuru | Sɛ woadi kan anya akisikuru a ɛma w’anim hohoro (angioedema) bere a woanom ACE inhibitor anaa ARB aduru akyi a. |
| Ɛnanom a wɔyem ne wɔn a wɔma nufu | Wɔnkamfo saa aduru yi nkyerɛ sɛ wɔmfa nni dwuma bere a wɔyem anaa bere a wɔrema nufu no. |
| Nnipa a wɔwɔ mmerɛbo mu yare a emu yɛ den | Sɛ wowɔ mmerɛbo mu yare a emu yɛ den a. |
| Nnipa a wɔnom nnuru afoforo | Sɛ worenom nnuru pɔtee afoforo te sɛ ACE inhibitors anaa aliskiren dedaw a. |
Mfaso bɛn na ɛwɔ ARNI aduruyɛ so?
Nhwehwɛmu ada no adi sɛ ARNI nnuru ma wonya mfaso atitiriw pii sen nnuru dedaw te sɛ ACE inhibitors.
- Nkwa nna a ɛkɔ soro: Wɔahu sɛ saa aduru yi brɛ asiane a ɛwɔ hɔ sɛ komayare betumi awu no ase, na ɛkyerɛ sɛ wubetumi atra ase apɔwmuden akyɛ.
- Asetra pa: Saa aduru yi boa wo ma woyɛ wo da biara da dwumadi ahorow ntɛmntɛm denam sɛnkyerɛnne ahorow te sɛ ɔbrɛ, ɔbrɛ, ne nan a ɛho ahonhon a ɛtew so no so.
- Mpɛn dodow a wɔde obi kɔ ayaresabea a ɛso tew: Nhwehwɛmu ada no adi sɛ ɛtew asiane a ɛwɔ hɔ sɛ wɔbɛtaa akɔ ayaresabea esiane komayare a ɛreyɛ kɛse nti no so bɛyɛ 20%.
- Koma a ɛsan yɛ adwuma: Ayarefo binom koma a wɔde pam nneɛma (ejection fraction) no tu mpɔn kɛse bere a wɔnom saa aduru yi bere tenten no.
Nhwehwɛmu kɛse bi daa no adi sɛ sɛ obi a wadi mfe 55 de saa aduru yi di dwuma a, obetumi atra ase mfe 2.1 foforo a wɔremfa wɔn nkɔ ayaresabea anaasɛ komayare ankum no.
So ɛsɛ sɛ yehu nea efi mu ba no nso?
Sɛnea ɛte wɔ nnuru biara ho no, ebia nsunsuanso nketenkete bi bɛba. Nanso mma ɛnhaw wo, wo duruyɛfo bɛkyerɛkyerɛ wo eyinom ho ade.
| Nneɛma bɔne a ebetumi afi mu aba | Dɛn na ɛsɛ sɛ yɛyɛ? |
|---|---|
| Mogya mmoroso a ɛba fam (Hypotension) . | Ebia w’adwene bɛba wo so, wo ti ayɛ hare, anaa w’ani ayɛ bruu. Wubetumi ne wo duruyɛfo akasa na woasesa bere a wode nom w’aduru no. |
| Nkɛntɛnso a enya wɔ asaabo dwumadi so | Sɛ wufi ase nom aduru no na asram kakraa biara a, wo duruyɛfo no bɛyɛ mogya mu nhwehwɛmu de ahwɛ sɛnea w’asaabo yɛ adwuma. Sɛ ɛho hia a, ɔbɛyɛ nsakrae wɔ dodow a wɔde ma no mu. |
| Potassium dodow a ɛkɔ soro wɔ mogya mu (Hyperkalemia) . | Wobetumi de mogya mu nhwehwɛmu nso ahu eyi. Oduruyɛfo no bɛhwɛ eyi nso yiye. |
| Angioedema a ɛma mogya tu | Eyi ho yɛ na koraa. Sɛ w’anim, w’ano, wo tɛkrɛma anaa wo menewa ho ahonhon, anaasɛ ɛyɛ den sɛ wobɛhome a, gyae aduru no nom ntɛm ara na kɔ ayaresabea dwumadibea a ɛbɛn wo a wɔhwɛ ntɛmpɛ so (ETU). |
Mpɛn pii no, saa nsunsuanso bɔne yi fi hɔ wɔ bɛyɛ adapɛn abien mu. Sɛ wɔanyɛ saa a, ka kyerɛ wo duruyɛfo. Ebia ɔbɛtew dodow a wɔde ma no so na afei wama akɔ soro bio wɔ nna kakraa bi akyi. Mma nnyae aduru no nom anaasɛ ɛnsesa dodow no da a wunnya wo duruyɛfo afotu.
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi bere a worenom ARNI a, ka kyerɛ wo duruyɛfo.
- Sɛ wunya adwenemhaw a emu yɛ den a
- Sɛ wote nka sɛ wo ti ayɛ hare na w’ani reyɛ bruu a
- Sɛ wote nka sɛ wo ho reyera a
- Sɛ wo mogya mmoroso akenkan no nnu 90 (systolic) .
Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka kakra sɛ wobɛdan akɔ aduru foforo so bere a woasua dedaw bi no. Nanso, ɛho hia nso sɛ wususuw mfaso a ayaresa foforo de bɛba w’asetra mu no ho. Wo ne wo duruyɛfo nka eyi ho asɛm pefee. Tie biribiara pefee fa mfaso ne ɔhaw ahorow a ɛwɔ aduru yi so, ne sɛ ebia ɛfata wo anaa. Afei wubetumi asi gyinae a ɛfata.
Nkrasɛm a Wɔde Kɔ Fie
- ARNI yɛ nnuru a edi mu yiye, nnɛyi nnuru a wɔde sa komayare.
- Eyi yɛ nnuru abien a wɔaka abom. Baako ma adesoa a ɛda koma no so no so tew, na biako nso bɔ abɔde mu nkwaadɔm a ɛboa koma no ho ban.
- ARNI ahorow wɔ tumi a ɛbɛma nkwa nna akɔ soro, atew ayaresabea a wɔde wɔn kɔ so, na ama asetra atu mpɔn bere a wɔde toto nnuru dedaw ho no.
- Sɛ woresakra afi ACE inhibitor so akɔ ARNI so a, ɛsɛ sɛ wugyaw nnɔnhwerew 36 kwan.
- Ɛho hia yiye sɛ wobɛyɛ mogya mu nhwehwɛmu wɔ mmere a wɔahyɛ ato hɔ sɛnea wo duruyɛfo de afotu ama wo no, efisɛ nneɛma bɔne te sɛ mogya mmoroso a ɛba fam ne asaabo a ɛsɛe betumi aba.
- Bere nyinaa wo ne wo duruyɛfo nsusuw ayaresa a eye ma wo ho pefee.
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