So mogya a ɛbɛtɔ wo ho asɛm haw wo? Ebia ɛhaw wo sɛ wobɛnya komayare anaa akisikuru. Wɔ nnipa a wɔwɔ asiane mu fam no, nnuruyɛfo kyerɛw aduru bi a wonim no sɛ "mogya a ɛma mogya tu." Enti ɛnnɛ yɛbɛka nnuru foforo, nanso ɛho hia yiye, adesuakuw bi ho asɛm. Ɛno ne Direct Thrombin Inhibitors.
Sɛ yɛbɛka no tiawa a, dɛn ne saa Direct Thrombin Inhibitors yi?
Eyinom ne nea yɛfrɛ no nnuru a ɛma mogya yɛ mmerɛw, anaasɛ nnuru a ekum mogya a ɛtwetwe mogya wɔ aduruyɛ mu. Wɔn adwuma ne sɛ wobesiw mogya a ɛtwetwe wɔ nipadua no mu a ɛho nhia no ano. Susuw ho hwɛ, nnipa dodow no ara a wɔwɔ wiase no wuwu esiane komayare nti. Enti nnuru ahorow yi boa kɛse ma mogya a ɛtwetwe mogya no nsiw mogya ntini a ɛde akwaa a ɛho hia te sɛ koma ne amemene ma no ano.
Ɛwom sɛ bere bi a atwam no, na wɔde nneɛma a ɛte sɛ protein bi a ɛwɔ atɛkyɛ nnompe mu na ɛyɛ saa nnuru yi de, nanso mprempren wɔde nnɛyi nnuru a wɔyɛ wɔ aduruyɛdan ahorow mu di dwuma.
Tebea bɛn na wɔde saa aduru yi di dwuma?
Nnuruyɛfo kamfo nnuru a ɛte sɛɛ a wɔfrɛ no direct thrombin inhibitors kyerɛ sɛnea ɛbɛyɛ a wobesiw tebea horow pii ano na wɔadi so. Momma yɛnhwɛ pon te sɛ eyi na ama nsɛm yi ase ayɛ mmerɛw.
| Tebea | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Atiridiinini a Ɛyɛ Hu a Ɛyɛ Hu | Mogya a ɛkɔ koma mu a ɛso tew mpofirim anaasɛ egyae esiane ntini bi a ɛde mogya kɔ koma no mu a asiw nti. |
| Thrombocytopenia (HIT) a heparin de ba . | Tebea a emu yɛ den a ɛma mogya mu nkwammoaa a ɛma mogya tu no so tew, na ɛno nso ma mogya mu ntini a ɛyɛ mmerɛw no yɛ. |
| Ntini mu Ntini a Ɛma Ntini Mu Ntini (VTE) . | Mogya a ɛtɔ gu nipadua no mu no ba na ɛkyekyere ntini bi a ɛwɔ nipadua no mu mu. |
| Akisikuru a Wosiw Ano wɔ Atrial Fibrillation (Afib) mu . | Siw akisikuru ano wɔ ayarefo a wonni koma ntini mu haw biara nanso wɔn koma bɔ ntɛmntɛm (Afib) no mu. |
| Bere a wɔayɛ wɔn asen foforo oprehyɛn akyi | Tew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ nan mu wɔ oprehyɛn akyi no so. |
| Ntini a Ɛkɔ Mu Ntini a Ɛyɛ Den (DVT) . | Mogya a ɛtɔ, titiriw wɔ ntini a emu dɔ a ɛwɔ nan no mu. |
| Ahurututu mu Nkwammoaa a Ɛyɛ Fɛ | Mogya a ɛwɔ nan no mu no bubu na ɛkɔhyɛ ntini bi a ɛwɔ ahurututu no mu mu. |
Nea ɛka ho no, wɔde saa aduru yi nso ma sɛ aduru a wɔde twitwiw nipadua no mu bere a wɔreyɛ ayaresa te sɛ angioplasty, a ebue ntini a ɛwɔ koma no mu no.
Ɔkwan bɛn so na saa aduru yi yɛ adwuma wɔ nipadua no mu?
Eyi yɛ mmerɛw yiye sɛ yɛbɛte ase. Nneɛma pii na ɛma mogya tu wɔ yɛn nipadua mu. Wɔn mu bi ne sɛ , "Thrombin" te sɛ mfiridwumayɛfo panyin a ɔwɔ adwumayɛbea bi a ɛma mogya tu. Ɔno na ɔma mogya a ɛbɛtɔ no ho ahyɛde.
Enti nea Direct Thrombin Inhibitor yi yɛ ne sɛ ɛkyekyere saa ade a wɔfrɛ no thrombin no tẽẽ na esiw no kwan sɛ ɔnyɛ n’adwuma. Ɛte sɛ obi a ɔrehuruw akɔ afiri a ɛma mogya tu anim na ɔde ne ho hyɛ wɔn adwuma mu. Sɛ thrombin gyae adwumayɛ a, adeyɛ a ɛma mogya tu no nyinaa gyae.
Nanso ɛtɔ mmere bi a, saa aduru yi tumi ma mogya tu dodo. Wɔ tebea horow a ɛtete saa mu no, aduru bi a wɔfrɛ no Idarucizumab wɔ hɔ a wɔde bɛdan aduru a wɔfrɛ no Dabigatran no nkɛntɛnso. Nanso, nnuru pɔtee biara nni hɔ a wɔde ko tia nnuru a wɔde fa ntini mu (IV) no. Nanso, sɛ wogyae aduru no pɛ a, ne nkɛntɛnso no sɛe wɔ nipadua no mu bere a bere kɔ so no.
Mfaso bɛn na ɛwɔ saa aduru yi so?
Sɛ wɔde toto nnuru a wɔde ma mogya a ɛyɛ mmerɛw dedaw ho a, saa aduru foforo yi wɔ mfaso pii.
- Nea afi mu aba no yɛ nea ɛyɛ pɔtee kɛse:Esiane sɛ saa aduru yi kyekyere thrombin nkutoo nti, nea efi mu ba no fã kɛse no ara yɛ nea ɛkɔ so pɛpɛɛpɛ. Eyi kyerɛ sɛ wubetumi ahwɛ kwan sɛ nea ebefi mu aba koro no ara bere biara a wobɛnom dodow koro no ara. Ɛho nhia sɛ wosakra dodow a wode ma no mpɛn pii sɛnea wobɛyɛ wɔ warfarin ho no.
- Ɛmma mogya mu nkwammoaa a ɛma mogya tu no so ntew: Eyinom mma mogya mu nkwammoaa a ɛwɔ mogya mu no so ntew te sɛ nnuru bi.
- Ɛho nhia sɛ wotaa yɛ mogya mu nhwehwɛmu: Sɛ worenom Warfarin a, ɛsɛ sɛ woyɛ mogya mu nhwehwɛmu daa de hwɛ sɛnea wo mogya mu yɛ den (INR nhwehwɛmu). Nanso saa aduru yi nhwehwɛ sɛ wɔyɛ saa.
- Asiane a ɛba fam ne nea ɛyɛ mmerɛw: Dabigatran a wɔnom sɛ aduru no, asiane a ɛwɔ hɔ sɛ mogya bɛtu no sua sɛ wɔde toto Warfarin ho a. Ɛne nnuru afoforo nso nni nkitaho kakraa bi. Ɛyɛ mmerɛw yiye nso sɛ wode bedi dwuma efisɛ wobetumi anom pɛnkoro anaa mprenu da biara.
- Ade pa a wɔde besi ananmu: Eyi yɛ ɔkwan pa a wɔfa so si ananmu ma wɔn a wontumi nnom aduru a wɔfrɛ no Heparin no.
Aduru yi tu mpɔn dɛn? So asiane bi wɔ hɔ?
Nhwehwɛmu ada no adi sɛ saa aduru yi yɛ nea asiane biara nni ho na etu mpɔn te sɛ Warfarin anaa Heparin. Nanso, kɔkɔbɔ biako a ɛho hia wɔ hɔ. Saa aduru yi mfata nnipa a wɔwɔ koma mu ntini a wɔde mfiri yɛ. Wo duruyɛfo betu wo fo wɔ eyi ho.
Nsonsonoe kɛse a ɛwɔ nnuru yi mu ne sɛ ɛtra nipadua no mu bere tiaa bi.
Fa no sɛ, sɛ wofa Warfarin dodow bi a, bɛyɛ ne fã betumi atra wo nipadua mu nnɔnhwerew 20-60. Nanso sɛ wonom aduru bi te sɛ Dabigatran a, ne fã fi wo nipadua mu wɔ nnɔnhwerew 12-14 mu.
Ade a ɛho hia sen biara a ɛsɛ sɛ yɛte ase fi eyi mu ne sɛ ɛnyɛ adwene pa sɛ yebehuw nnuru dodow bi so esiane biribiara nti . Sɛ wopa dodow bi a, aduru no nkɛntɛnso bɛsɛe ntɛmntɛm, na asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo no betumi ayɛ kɛse mpofirim.
Dɛn ne nsunsuanso bɔne ne nsɛnnennen a ebetumi afi mu aba?
Te sɛ nnuru biara no, eyinom betumi anya ɔhaw ahorow. Bere a ebinom yɛ nea ɛfata no, afoforo nso hwehwɛ sɛ yɛhwɛ yiye paa.
Nea efi mu ba titiriw ne nea ɛyɛ hu sen biara ne mogya a ɛtɔ dodo (Bleeding complications). Nea ɛka ho no, nea edidi so yi betumi aba:
- Yafunu mu yare, ɔfe (Dyspepsia) .
- Yafunu mu yaw
- Nsu a ɛyɛ bruu anaa pink
- Tipaeɛ
- Mogya mmoroso a ɛba fam (Hypotension) .
- Koko mu yaw
- Adwene a ɛyɛ basaa
- Ɔhome a ɛyɛ den
- Huraeɛ
- Sepsis (sɛnea nipadua no yɛ n’ade denneennen wɔ ɔyare mmoawa bi ho) .
- Koma a ɛyɛ den
Bere bɛn na ɛsɛ sɛ mefrɛ oduruyɛfo no?
Sɛ wunya ɔhaw biara bere a wode aduru yi redi dwuma a, ka kyerɛ wo duruyɛfo ntɛm ara.
Titiriw sɛ sɛnkyerɛnne ahorow bi wɔ hɔ a ɛkyerɛ sɛ mogya retu kɛse a, ɛyɛ nea egye ntɛmpɛ.Sɛ nhwɛso no, sɛ kuru bi nnyae mogya, sɛ wo nsu mu yɛ tuntum, sɛ wofe mogya, anaasɛ wo ti yɛ wo yaw kɛse a, kɔ ayaresabea a ɛbɛn wo no Dwumadibea a Ɛho Hia Ntɛmntɛm (ETU) ntɛm ara. Ntwentwɛn wo nan ase.
Nkrasɛm a Wɔde Kɔ Fie
- Direct Thrombin Inhibitors yɛ nnuru a ano yɛ den yiye a ɛmma mogya ntumi nkɔ. Fa dodow a wo duruyɛfo akyerɛ wo no bere nyinaa, wɔ bere a ɛfata mu.
- Mma ntwa nnuru dodow bi so esiane biribiara nti. Saa a wɔyɛ no ma asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse. Sɛ wo werɛ fi sɛ wobɛnom dodow bi a, bisa wo duruyɛfo ntɛm ara nea ɛsɛ sɛ woyɛ akyi.
- Hwɛ yiye wɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ mogya retu kɛse (nsu a ɛyɛ tuntum, mogya a ɛfe, mogya a ɛkɔ so tu). Sɛ eyi ba a, kɔ ETU ntɛm ara.
- Saa aduru yi mfata obiara (titiriw wɔn a wɔwɔ koma mu ntini a wɔde mfiri yɛ), enti hwɛ hu sɛ wobɛka w’ayaresa ho abakɔsɛm nyinaa akyerɛ wo duruyɛfo.
- Sɛ woreyɛ ayaresa foforo biara (a woyi wo sẽ mpo) a, ka kyerɛ oduruyɛfo no sɛ worenom saa aduru yi.
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