So wunim sɛ ɛtɔ mmere bi a mogya a ɛsen fa wo ntini mu no tumi twetwe a ɛho nhia? Sɛ mogya a ɛte saa kɔ amemene no mu a, ebetumi ama obi anya akisikuru, na sɛ ɛkɔ koma no mu a, ebetumi ama obi anya komayare. Enti ɛnnɛ yɛrebɛka nnuru soronko bi a nnuruyɛfo de siw tebea horow a ɛyɛ hu yi ano ho asɛm. Wɔfrɛ eyinom Direct Thrombin Inhibitors.
Sɛ yɛbɛka no tiawa a, dɛn ne saa Direct Thrombin Inhibitors yi?
Eyinom yɛ nnuru kuw bi a ɛmma mogya ntumi nkɔ. Wɔyɛ nea yɛtaa frɛ no "mogya a ɛma mogya tu." Nanso ɔkwan a wɔfa so yɛ adwuma no yɛ soronko kakra. Adwene a wɔde yɛ nnuru yi gyina protein bi a ɛwɔ akutu nnompe mu so. Ebia woate sɛ bere bi a atwam no, na wɔde akutu nso di dwuma de sa yare.
Nnipa dodow no ara a wɔwɔ wiase no wuwu esiane komayare nti. Ade titiriw nti a ɛte saa ne mogya a ɛtwetwe. Enti nnuruyɛfo kyerɛw nnuru te sɛ eyi de gye nkurɔfo fi asiane yi mu.
Tebea bɛn na wɔde saa aduru yi di dwuma?
Wɔtaa de nnuru kuw yi a wɔfrɛ no direct thrombin inhibitors di dwuma de siw mogya a ɛtwetwe a aduruyɛ mu tebea horow de ba no ano anaasɛ wɔsa. Momma yɛnhwɛ nea wɔyɛ.
| Yare tebea | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Acute coronary syndrome (mogya a ɛnkɔ koma no mu a ɛnkɔ yiye) . | Ntini a ɛde mogya kɔ koma no mu a esiw anaasɛ mogya no kɔ brɛoo. |
| Heparin a ɛma mogya mu nkwammoaa a ɛma mogya tu (HIT) . | Ɔhaw a mogya mu aduru foforo a wɔfrɛ no heparin de ba. |
| Ntini mu ntini a ɛma mogya tu (VTE) . | Mogya a ɛtɔ wɔ ntini bi mu wɔ nipadua no mu. |
| Atiridiinini a Ɛyɛ Fɛ (Afib) . | Asiane a ɛwɔ hɔ sɛ mogya bɛtɔ ne akisikuru esiane koma a ɛbɔ a ɛnkɔ so daa nti. |
| Bere a wɔayɛ wɔn asen foforo oprehyɛn akyi | Tew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wɔ oprehyɛn akyi no so. |
| Mogya a ɛtɔ wɔ ntini a emu dɔ mu wɔ nan no mu (Deep vein thrombosis - DVT) . | Mogya a ɛtɔ, titiriw wɔ nan no ntini a emu dɔ no mu. |
| Mogya a ɛtɔ wɔ ahurututu mu (Pulmonary embolism) . | Mogya a ɛtwetwe a ɛba nipadua no mu baabi foforo no tu kwan kɔ ahurututu no mu na ɛdan. |
Bio nso, wobetumi ama wo saa aduru yi bere a wɔreyɛ ayaresa te sɛ angioplasty a ɛma ntini a ɛwɔ koma no mu no bue no.
Nnuru bɛn na ɛka saa kuw yi ho?
Nnuru ahorow pii wɔ hɔ a wɔde siw thrombin ano tẽẽ a mprempren wɔtaa de di dwuma wɔ Sri Lanka ne wiase nyinaa.
- Argatroban (wɔde eyi ma sɛ IV injection) .
- Bivalirudin (wɔde eyi nso ma sɛ aduru a wɔde fa ntini mu - IV injection) .
- Dabigatran (eyi ne nea wofa sɛ aduru) .
Ɔkwan bɛn so na saa aduru yi yɛ adwuma wɔ nipadua no mu?
Ɛnyɛ den koraa. Sɛnea edin no kyerɛ no, saa aduru yi kɔ enzyme bi a wɔfrɛ no Thrombin so tẽẽ na ɛma ɛnyɛ adwuma.
Afei ebia worebisa sɛ dɛn ne saa Thrombin yi. Sɛ yɛbɛka no tiawa a, Thrombin yɛ ade titiriw a ɛma mogya tu wɔ yɛn nipadua mu. Ɛte sɛ nea aduannoafo titiriw no resiesie aduan. Nea aduru yi yɛ ne sɛ ɛde saa aduannoafo no to nkyɛn. Afei mogya a ɛtwetwe no nkɔ so yiye. Enti mogya a ɛtwetwe a ɛho nhia a ɛba no gyae. So wote ase?
Nanso ɛtɔ mmere bi a, saa aduru yi tumi ma mogya tu kɔ soro. Injection soronko bi wɔ hɔ a ebetumi adan nkɛntɛnso a aduru a wɔfrɛ no Dabigatran no de ba no. Wɔfrɛ no `Idarucizumab`. Nanso, aduru titiriw biara nni hɔ a wɔde ko tia aduru a wɔde fa ntini mu no. Nanso, sɛ wogyae aduru no pɛ a, ne nkɛntɛnso bɛsɛe wɔ bere bi akyi.
Bere tenten ahe na ɛsɛ sɛ menom saa aduru yi?
Ɛsono nnipa biara. Ɛho hia sɛ nnipa binom nom bere tiaa bi pɛ, te sɛ ɔsram biako wɔ oprehyɛn a wɔde sesa wɔn asen akyi. Nanso ebia ɛho behia sɛ obi a asiane kɛse wom sɛ mogya bɛtɔ no nom saa aduru yi ne nkwa nna nyinaa . Wo duruyɛfo no besi nea ɛsɛ sɛ woyɛ ankasa ho gyinae.
Mfaso bɛn na ɛwɔ saa aduru yi so?
Nnuru foforo yi wɔ mfaso pii sen nnuru dedaw.
- Nea efi mu ba no yɛ ade koro: Esiane sɛ eyinom ka Thrombin tẽẽ nkutoo nti, wubetumi ahwɛ kwan sɛ nea ebefi mu aba koro no ara afi dodow koro no ara mu bere biara.
- Nkwammoaa a ɛma mogya tu no so tew: Nea ɛnte sɛ nnuru dedaw bi no, eyinom mma mogya mu nkwammoaa a ɛboa ma mogya tu no nkɔ fam.
- Ɛho nhia sɛ wɔtaa yɛ wo mogya mu nhwehwɛmu: Nnuru bi te sɛ Warfarin hwehwɛ sɛ wɔyɛ mogya mu nhwehwɛmu daa na ama wɔahu sɛnea wo mogya no retu ntɛmntɛm. Nanso saa aduru yi nhwehwɛ sɛ wɔyɛ saa.
- Nsunsuanso bɔne kakraa bi: Dabigatran a wɔnom sɛ aduru no, asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no sua na ɛne nnuru afoforo di nkitaho bere a wɔde toto Warfarin ho no.
- Ɛnyɛ den sɛ wode bedi dwuma: Ɛnyɛ den yiye sɛ wode bedi dwuma efisɛ ɛsɛ sɛ wonom aduru pɛnkoro anaa mprenu pɛ da biara.
- Ɔkwan foforo: Eyinom yɛ ɔkwan pa a wobetumi afa so ama wɔn a wontumi mfa nnuru te sɛ Heparin nni dwuma.
Aduru yi tu mpɔn dɛn? Na asiane ahorow bɛn na ɛwɔ mu?
Nhwehwɛmu ada no adi sɛ saa aduru yi yɛ nea asiane biara nni ho na etu mpɔn te sɛ Warfarin anaa Heparin. Nanso, ɛnyɛ nea ɛfata nnipa a wɔwɔ komayare ahorow bi.
Nanso ade a ɛho hia sen biara wɔ ha ne sɛ bere a aduru yi tra nipadua no mu no so tew. Sɛ nhwɛso no, sɛ wofa Warfarin dodow bi a, bɛyɛ 50% betumi akɔ nipadua no mu nnɔnhwerew 20-60. Nanso sɛ wofa Dabigatran a, woyi ne 50% fi nipadua no mu wɔ nnɔnhwerew 12-14 ntam.
Dɛn na eyi kyerɛ? Worentumi nnyae da koro mpo a wobɛnom saa aduru yi. Sɛ wopa da koro pɛ a wobɛnom a, asiane a ɛwɔ hɔ sɛ wobɛma mogya atɔ wo mu no kɔ soro kɛse.
Nneɛma bɔne a ebetumi afi mu aba
Te sɛ aduru biara no, eyi betumi anya ɔhaw ahorow, na ebi betumi ayɛ nea anibere wom.
| Nsunsuanso bɔne | Nkyerɛmu |
|---|---|
| Mogya a ɛtɔ dodo | Mogya a efi anom, hwene mu mogya, anaa kuru a ennyae mogya. |
| Nnuan a wɔmfa nni dwuma yiye (Dyspepsia) . | Yafunu mu yaw, a ɛnyɛ dɛ. |
| Nsu kɔla a ɛsakra | Nsu a ɛdannan bruu anaa pink. |
| Tiyɛ, adwenemhaw | Tiyɛ anaa adwenemhaw a ɛkɔ so wɔ ɔkwan a ɛkɔ akyiri so. |
| Koko mu yaw, ɛyɛ den sɛ wobɛhome | Eyinom betumi ayɛ sɛnkyerɛnne ahorow a anibere wom. |
| Atiridiinini, ɔyare mmoawa (Sepsis) . | Tebea horow a emu yɛ den a ɔyare mmoawa bi de ba. |
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Sɛ wunya ɔhaw biara bere a wode aduru yi redi dwuma a, ka kyerɛ wo duruyɛfo ntɛm ara.
Titiriw no, sɛ mogya retu wo boro so (sɛ nhwɛso no, sɛ wuntumi nnyae mogya a efi kuru bi mu, sɛ mogya wɔ wo nsu mu, sɛ wo hwene mu mogya retu wo a ɛrema wo ho popo) anaasɛ sɛ wowɔ sɛnkyerɛnne afoforo a emu yɛ den (a wo koko mu yɛ wo yaw kɛse, ɛyɛ den sɛ wobɛhome) a, kɔ ayaresabea a ɛbɛn wo Emergency Department (ETU) a wontwentwɛn wo nan ase.
Awiei koraa no, ɛho nhia sɛ yesuro sɛ mogya bɛtu. Nnɛyi nnuru te sɛ nnuru a esiw thrombin ano tẽẽ betumi adi saa asiane no so kɛse. Nanso wo duruyɛfo no besi aduru a eye ma wo ne bere tenten a ɛsɛ sɛ wonom no ho gyinae. Enti di wo duruyɛfo afotu akyi bere nyinaa.
Nkrasɛm a Wɔde Kɔ Fie
- Direct Thrombin Inhibitors yɛ nnuru foforo a ɛmma mogya ntumi nkɔ.
- Eyinom yɛ adwuma denam thrombin, enzyme titiriw bi a ɛma mogya tu no ma ɛnyɛ adwuma tẽẽ no so.
- Sɛ wode saa aduru yi di dwuma aMma nnhuw nnuru dodow bi so da. Saa a wɔyɛ no ntɛm ara no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse.
- Sɛ wuhu sɛ mogya retu wo dodo anaa sɛnkyerɛnne afoforo a ɛyɛ soronko a, kɔ wo duruyɛfo nkyɛn ntɛm ara.
💬 Comments (0)
Wɔnnya nyɛɛ nsɛm biara. Fa wo nsɛm no ka ho wɔ ha nea edi kan.
Fa wo nsɛm no ka ho