So wo anaa w’abusua mu bi wɔ komayare? Sɛ saa a, ebia nnuru a wo duruyɛfo kyerɛw ma wo no ho hia wo bere nyinaa. Sɛ wo koma te nka sɛ wabrɛ kakra a, ɛho hia paa sɛ wohwɛ nnuru a ebetumi aboa no bere nyinaa. Ɛnnɛ yɛrebɛka aduru foforo bi a ɛda adi sɛ ɛyɛ nea edi mu yiye wɔ tebea yi a wɔsa mu ho asɛm. Ɛno ne ARNI.
Sɛ yɛbɛka no tiawa a, dɛn ne ARNI?
ARNI yɛ nnuru abien a wɔaka abom ankasa. Ne din nyinaa ne Angiotensin Receptor/Neprilysin Inhibitor. Ɛwom sɛ ebia edin no bɛyɛ te sɛ nea ɛyɛ den kakra de, nanso nokwarem no, ɛyɛ mmerɛw koraa. Wɔayɛ no sɛ wɔde bɛsa ayarefo a wɔn koma ayɛ adwuma yiye.
Nneɛma atitiriw abien a ɛwɔ aduru yi mu ne:
1. ARB (Angiotensin II Receptor Blocker): Aduru ‘Valsartan’ ka saa kuw yi ho.
2. Neprilysin Inhibitor: Aduru a wɔfrɛ no ‘Sacubitril’ no ka kuw yi ho.
ARNI aduru biako pɛ a ɛwɔ wiase mprempren a ɛka abien yi bom ne Sacubitril/Valsartan . Wɔpenee eyi so wɔ afe 2015 mu.
Ɔkwan bɛn so na saa aduru yi yɛ adwuma wɔ nipadua no mu?
Okay, afei ma yɛnhwɛ sɛnea nnuru abien yi bom betumi aboa wo koma.
Fa mogya ntini a ɛwɔ wo nipadua mu no sɛ nsu afiri a ɛde nsu kɔ. Ɛtɔ mmere bi a, saa nsu afiri yi siw na ɛyɛ teateaa, na ɛma ɛyɛ den ma wo koma sɛ ɛbɛtwe mogya.
- Valsartan (ARB kuw): Saa aduru yi yɛ adwuma denam mogya ntini a ayɛ teateaa a ɛma ɛyɛ mmerɛw na ɛtrɛw so. Ɛte sɛ nea woretrɛw paipu a asiw mu. Afei mogya no tumi sen fa nipadua no nyinaa mu a biribiara nsiw kwan. Eyi ma mogya mmoroso so tew.
- Sacubitril (Neprilysin Inhibitor): Eyi yɛ biribi a ɛho hia kɛse mpo. Yɛn nipadua fi awosu mu yɛ nkwaadɔm a ɛboa yɛn koma. Nanso enzyme bi a wɔfrɛ no ‘Neprilysin’ sɛe saa hormone pa yi. Sacubitril siw saa enzyme bɔne no kwan sɛ ɛnyɛ adwuma. Sɛ egyae a, yɛn nipadua betumi:
- Fa nsu mu yi sodium (nkyene) a ɛho nhia fi nipadua no mu.
- Ma mogya ntini no ntrɛw.
- Ma nsu pii ba na tew nsu a ɛboro so wɔ nipadua no mu so.
Sɛ yɛbɛka no tiawa a, nnuru abien yi a wɔde ka bom no ma adesoa a ɛda koma no so no so tew na ɛma n’adwuma yɛ mmerɛw kɛse. Ɛte sɛ nea nnipa baanu foforo aba bɛboa obi a ɔreyɛ adwumaden.
Henanom na wɔkamfo ARNI kyerɛ?
Saa aduru yi nyɛ nea wɔde ma obiara. Wo duruyɛfo begyina nneɛma pii so asi gyinae sɛ saa aduru yi fata wo anaa.
| Fata a Wɔfata | Nkyerɛmu |
|---|---|
| Wɔn a wɔn koma no tumi a wɔde bɔ pɔmpɛ so tew no fam | Sɛ wɔahu sɛ woanya Koma a Ɛyɛ Den foforo na wo Ejection Fraction (EF) , a ɛyɛ nea ɛkyerɛ sɛnea koma no tumi bɔ no yiye no yɛ 40% anaa nea ennu saa (wɔ obi a ɔwɔ apɔwmuden mu no, saa bo yi bɛyɛ 55%-65%). |
| Wɔn a wɔresakra afi nnuru afoforo so no fam | Sɛ worenom ACE inhibitors anaa ARBs dedaw ama komayare a, wubetumi adan akɔ ARNIs so mmom. |
Ɛho hia yiye: Sɛ woresakra afi ACE inhibitor (e.g. Enalapril, Lisinopril) so akɔ ARNI so a, twɛn nnɔnhwerew 36 bere a woagyae ACE inhibitor no akyi ansa na woafi ARNI ase. Sɛ wɔantumi anyɛ saa a, ebetumi ama obi anya akisikuru a asiane wom (angioedema), a ɛyɛ honam ani a ɛho ahonhon. Wo duruyɛfo betu wo fo wɔ eyi ho.
Mfaso a ɛwɔ ARNI so ne ntease ahorow a enti ɛsɛ sɛ wɔde di dwuma
Nnipa pii dan kɔ ARNI so esiane nsunsuanso bɔne te sɛ ɔfe a ɛkɔ so daa a ɛka nnuru dedaw te sɛ ACE inhibitors ho nti. Nanso ɛnyɛ ɛno nkutoo nti na ɛte saa. Mfaso pii wɔ ARNI ahorow a wɔde di dwuma no so.
- Ɛma nkwa nna yɛ kɛse: Nhwehwɛmu ahorow ada no adi sɛ saa aduru yi brɛ owu a ɛbata komayare ho no ase.
- Ɛma asetra tu mpɔn: Ɛtew sɛnkyerɛnne ahorow te sɛ ɔbrɛ ne ɔbrɛ so, na ɛboa ma woyɛ adwuma sɛnea ɛsɛ.
- Ɛhwɛ sɛnea yare no kɔ so: Ɛbrɛ sɛnea komayare no mu yɛ den no ase.
- Ɛtew ayaresabea a wɔde wɔn kɔ so: Wɔada no adi sɛ nnipa a wɔnom aduru yi ntaa nkɔ ayaresabea esiane komayare nti.
- Ɛma koma no yɛ adwuma yiye: Nhwehwɛmu bi kyerɛe sɛ bere a wɔnom ARNI afe biako akyi no, ayarefo no fã a wɔtow no fi nipadua no mu no kɔɔ soro fi 28% koduu 38%. Eyi kyerɛ sɛ tumi a koma no tumi de pɔmpɛ no nyaa nkɔso kɛse.
Sɛnea nhwehwɛmu kɛse bi kyerɛ no, nnipa a wɔnom ARNI no asiane a ɛwɔ hɔ sɛ wobewuwu anaasɛ wɔde wɔn bɛkɔ ayaresabea esiane komayare nti no so tew 20%.
Henanom na ɛnsɛ sɛ wɔde saa aduru yi di dwuma?
Saa aduru yi mfata nnipa binom. Sɛ woka akuw yi mu biara ho a, nnuruyɛfo ka sɛ ɛnsɛ sɛ wonom saa aduru yi.
| Gyinabea | Sɛnti |
|---|---|
| Ɛnanom a wɔyem anaa wɔma nufu | Efisɛ na ebetumi apira akokoaa no. |
| Nnipa a wɔadi kan anya angioedema | Sɛ woadi kan anya angioedema, anim anaa w’anofafa a ɛho ahonhon, esiane ACE inhibitor anaa ARB aduru bi nti a. |
| Wɔn a wɔnom ACE inhibitor/ARB dedaw no | Asiane wom sɛ wobɛnom nnuru abien no nyinaa abom. |
| Nnipa a wɔwɔ mmerɛbo mu yare a emu yɛ den | Saa aduru yi mfata sɛ wo mmerɛbo nyɛ adwuma yiye a. |
| Nnipa a wɔrenom Aliskiren | Ɛnyɛ papa sɛ wobɛnom ARNI sɛ worenom Aliskiren a wowɔ asikreyare anaa asaabo mu yareɛ a. |
Momma yensua nsunsuanso bɔne nso ho ade.
Te sɛ aduru biara no, ARNI betumi de ɔhaw nketenkete aba. Nanso, ɛnyɛ obiara na onya bi.
- Mogya mmoroso a ɛba fam (Hypotension): Ebia wobɛte nka sɛ wo ti ayɛ wo yaw na wo ti ayɛ wo hare.
- Nkɛntɛnso a enya wɔ asaabo dwumadi so: Ebia nnipa binom behu sɛ asaabo dwumadi so tew kakra.
- Potassium dodow a ɛkɔ soro wɔ mogya mu (Hyperkalemia): Eyi nso betumi aba nnipa binom mu.
- Angioedema: Anim, anofafa, ne tɛkrɛma a ɛho ahonhon. Eyi ho yɛ na yiye , nanso sɛ ɛba a, ebetumi ayɛ asiane kɛse.
Eyi nti na wo duruyɛfo bɛhwɛ wo mogya (de ahwɛ w’asaabo ne potassium dodow) ne mogya mmoroso wɔ adapɛn kakraa a edi kan bere a woafi ase anom aduru yi no. Sɛ ɔhaw bi wɔ hɔ a, wo duruyɛfo no bɛtew dodow no so anaasɛ ɔbɛkyerɛ wo nea ɛsɛ sɛ woyɛ. Nnyae saa aduru yi nom da a wunnyaa wo duruyɛfo afotu.
Mpɛn pii no, saa nsunsuanso bɔne yi fi hɔ wɔ adapɛn abien ntam. Sɛ wɔkɔ so tra hɔ a, ka kyerɛ wo duruyɛfo ntɛm ara.
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi bere a worenom ARNI a, hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa.
- Adwene a ɛtaa yɛ no yaw
- Ti a ɛyɛ hare
- Ɛtɔ mmere bi a, ɔtotɔ piti
- Mogya mmoroso a ɛba fam yiye (sɛ systolic akenkan no nnu 90 a) .
Ebia wusuro kakra sɛ wobɛdan akɔ aduru foforo so bere a woasua dedaw bi no. Nanso ayaresa foforo a etu mpɔn a wubesua na wo ne wo duruyɛfo akasa afa wɔn mfaso ne ɔhaw ahorow ho no ho hia kɛse ma w’akwahosan.
Nkrasɛm a Wɔde Kɔ Fie
- ARNI yɛ nnɛyi aduru a edi mu a wɔde nnuru abien a wɔaka abom a wɔde sa komayare.
- Eyi ma mogya ntini trɛw, yi nkyene ne nsu a ɛho nhia fi nipadua no mu, na ɛtew adesoa a ɛda koma no so no so.
- Saa aduru yi ma wonya mfaso pii, a nea ɛka ho ne nkwa nna a ɛkɔ soro, asetra pa a ɛkɔ anim, ne ayaresabea a wɔtew so.
- Saa aduru yi mfata mma mmea a wɔyem, wɔn a wɔadi kan anya angioedema, ne wɔn a wɔwɔ ayaresa mu tebea afoforo bi.
- Nsunsuanso bɔne te sɛ adwenemhaw ne mogya mmoroso a ɛba fam betumi aba. Enti, ɛho hia sɛ yɛtra oduruyɛfo hwɛ ase bere nyinaa.
- Mfi ase anaasɛ nnyae aduru yi nom da a wunni aduruyɛ mu afotu. Sɛ wowɔ ɔhaw bi a, kɔ wo duruyɛfo nkyɛn ntɛm ara.
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