Ua kuhikuhi ʻia anei kēia lāʻau lapaʻau no ke koko kiʻekiʻe? E aʻo kākou i nā mea āpau e pili ana i nā ACE Inhibitors!

ʻO kahi pilikia i loaʻa i nā poʻe he nui ma Sri Lanka, ʻo ia ke koko kiʻekiʻe, a i ʻole "kaomi" e like me kā mākou e ʻike nei. No laila, ua kuhikuhi paha kāu kauka iā ʻoe i ka lāʻau lapaʻau no kou koko, a i ʻole no kekahi maʻi puʻuwai. Ma waena o nā ʻano lāʻau lapaʻau i kuhikuhi ʻia, ʻo nā ACE Inhibitors kahi papa lāʻau maʻamau a koʻikoʻi loa. Inā ʻo ka inoa o kāu lāʻau lapaʻau he mea like me Captopril, Enalapril, Lisinopril, a laila ke hoʻohana nei paha ʻoe i kēia ʻano lāʻau lapaʻau. No laila i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o kēia mau ACE Inhibitors, pehea lākou e hana ai i loko o ko mākou kino, a he aha nā mea nui e pono ai mākou e ʻike i ka wā e hoʻohana ai iā lākou.

I ka ʻōlelo maʻalahi, he aha kēia mau ACE Inhibitors?

ʻO Angiotensin - Converting Enzyme Inhibitors ka inoa piha o kēia. ʻOiai he paʻakikī iki ka inoa, he maʻalahi loa kāna hana. No ka hoʻomaopopo ʻana i kēia, e kamaʻilio kākou e pili ana i kahi kaʻina hana liʻiliʻi e hana ʻia ana i loko o ko kākou kino.

Hana nā ʻano hormones a me nā enzymes like ʻole e kaohi i ke koko i loko o ko mākou kino. ʻO kekahi o nā enzymes nui i kapa ʻia ʻo 'ACE (Angiotensin-Converting Enzyme). Ua like kēia enzyme 'ACE' me kahi hale hana liʻiliʻi i loko o ko mākou kino. Hoʻololi kēia hale hana i ka mea 'Angiotensin I' i loko o ko mākou kino i kekahi mea ikaika ʻē aʻe i kapa ʻia ʻo 'Angiotensin II'.

ʻO kēia kanaka i kapa ʻia ʻo 'Angiotensin II' ka mea e hana ai e hoʻonui i ko mākou koko. Hana ʻo ia i ʻelua mau mea nui:

1. Hoʻopaʻa ʻia nā kīʻaha koko: E like me ka wā e ʻomi ʻia ai kahi paipu wai, kahe wikiwiki ka wai, i ka wā e paʻa ai nā kīʻaha koko, emi ka hakahaka no ke kahe ʻana o ke koko, a piʻi aʻe ke kaomi i loko o nā kīʻaha koko.

2. Hoʻopaʻa i ka hoʻokuʻu ʻana o ka paʻakai a me ka wai mai nā puʻupaʻa: Ke mālama nui ʻia ka paʻakai a me ka wai i loko o ke kino, piʻi ka nui o ke koko, a laila e hoʻonui ai i ke koko.

ʻAʻole wale ia, hoʻopau kēia enzyme 'ACE' i kahi protein i kapa ʻia ʻo 'Bradykinin', he mea pono ia no ko mākou kino a hoʻonui i nā kīʻaha koko. Ke lawe ʻoe i kahi ACE inhibitor, no ka mea, ʻaʻole hana ka enzyme 'ACE', ʻoi aku ka nui o kēlā protein maikaʻi i kapa ʻia ʻo 'Bradykinin' i loko o ke kino.

I ka ʻōlelo maʻalahi, hoʻōki nā mea hoʻopaʻa ACE i ka hana ʻana o nā mea e hoʻonui ai i ke koko a pale i ka nalowale ʻana o nā mea e hoʻemi ai i ke koko. Kōkua kēia hana pālua i ka hoʻomalu maikaʻi ʻana i ke koko.

No nā kūlana hea e kuhikuhi ai nā kauka i kēia lāʻau lapaʻau?

ʻAʻole wale nā ​​​​​​mea hoʻōki koko he lāʻau lapaʻau koko nā ACE Inhibitors. Kōkua pū lākou i ka pale ʻana i ka puʻuwai a me nā puʻupaʻa, no laila ke kuhikuhi nei nā kauka iā lākou no nā ʻano maʻi like ʻole.

• Kaohi i ke koko kiʻekiʻe:ʻO kēia ka mea nui loa a hoʻohana pinepine ʻia.
• E mālama i ka hāʻule ʻana o ka puʻuwai: Ke hiki ʻole i ka puʻuwai ke pamu i ke koko kūpono, kōkua kēia lāʻau lapaʻau e hōʻemi i ka ukana hana ma ka puʻuwai a kōkua iā ia e hana.
• Ma hope o ka hōʻeha puʻuwai: Hāʻawi ʻia kēia lāʻau lapaʻau e kōkua i ka puʻuwai e hoʻōla ma hope o ka hōʻeha puʻuwai a pale i ka hōʻino hou aʻe.
• E pale i nā puʻupaʻa o ka poʻe me ka maʻi diabetes: Hiki i ka maʻi diabetes ke hōʻino i nā puʻupaʻa i ka hala ʻana o ka manawa. Hiki i nā mea hoʻopaʻa ACE ke kōkua i ka hoʻopaneʻe a pale i kēlā hōʻino.
• No ka poʻe i loaʻa i ka pilikia nui o ka hōʻeha puʻuwai a me ka hahau: Ua kuhikuhi ʻia kēia mau mea e pale aku i kēia mau kūlana mai ka hiki ʻana mai i ka poʻe i loaʻa i ka pilikia.
• No nā maʻi puʻupaʻa ʻē aʻe: Hoʻohana ʻia kēia mau mea no kekahi mau maʻi puʻupaʻa (e like me ka `Nephrotic syndrome`, `Proteinuria`) e kū nei i nā poʻe me ka ʻole o ka maʻi diabetes.

He aha nā ʻano ACE inhibitors i hoʻohana nui ʻia?

Aia kekahi mau ʻano ACE inhibitors ma ka mākeke. Loaʻa paha i kāu lāʻau lapaʻau kekahi o nā inoa i helu ʻia ma lalo nei. E hoʻomanaʻo ʻoiai like ka inoa generic o ka lāʻau lapaʻau, ʻokoʻa paha ka inoa brand no ka mea ua hana ʻia e nā ʻoihana like ʻole.

Pehea e pono ai iaʻu ke hoʻohana i kēia lāʻau lapaʻau?

Ua kuhikuhi ʻia ka hapa nui o nā kānaka i kahi ACE inhibitor i hoʻokahi manawa i ka lā. Eia nō naʻe, pono paha kekahi poʻe e lawe iā ia i ʻelua manawa i ka lā. Na kāu kauka kēia e hoʻoholo.

ʻO kahi mea nui loa ka mea e hana ai inā ʻoe e poina i kahi lāʻau. E noʻonoʻo ua poina iā ʻoe e lawe i kāu lāʻau kakahiaka. Inā hoʻomanaʻo ʻoe i ke ao, e lawe koke iā ia i kou hoʻomanaʻo ʻana. Akā inā hoʻomanaʻo ʻoe i ke kakahiaka aʻe, ʻo ia hoʻi ua kokoke ka manawa no kāu lāʻau aʻe, mai lawe i ka lāʻau i poina. E hōʻalo iā ia a lawe wale i ka lāʻau aʻe i ka manawa i hoʻonohonoho ʻia. Mai lawe i ʻelua mau pila i ka manawa hoʻokahi, me ka mea āu i poina ai. ʻO ka hana ʻana pēlā e hiki ai i kou koko ke hāʻule haʻahaʻa loa a hoʻoulu i ka poniuniu.

He aha nā pōmaikaʻi a me nā hopena ʻaoʻao o kēia lāʻau lapaʻau?

ʻO nā ACE Inhibitors kahi papa o nā lāʻau lapaʻau a nā kauka a puni ka honua e hilinaʻi nei no kekahi mau kumu.

Nā pono nui

• Loaʻa ka pono: Ua hōʻoia ka noiʻi ʻepekema he mea pono loa kēia i ka kaohi ʻana i ke koko a me nā maʻi puʻuwai.
• Kāohi i nā maʻi: ʻAʻole wale ia e mālama i kahi maʻi e kū nei, akā kōkua pū kekahi i ka pale ʻana i nā hōʻeha puʻuwai, nā hahau, a me nā maʻi puʻupaʻa i ka wā e hiki mai ana.
• Kūlike me nā lāʻau lapaʻau ʻē aʻe: I kekahi manawa kuhikuhi nā kauka i hoʻokahi pila e hui pū ana i kahi ACE inhibitor a me kekahi lāʻau lapaʻau koko ʻē aʻe.
• Palekana: ʻO ka maʻamau, he liʻiliʻi nā hopena ʻaoʻao o kēia mau lāʻau. He kākaʻikahi nā hopena ʻaoʻao koʻikoʻi, no laila hiki ke hoʻohana palekana ʻia no ke ola holoʻokoʻa.

Nā hopena ʻaoʻao hiki ke loaʻa

E like me nā lāʻau lapaʻau āpau, hiki i kēia ke hana i nā hopena ʻaoʻao liʻiliʻi i kekahi poʻe.

Nā mea e makaʻala ai i ka wā e hoʻohana ai i kēia lāʻau lapaʻau

ʻO ka poʻe pono ʻole e lawe i kēia lāʻau lapaʻau

• Nā makuahine hāpai a hānai waiū paha. (Inā ʻoe e hāpai ana i kahi pēpē, e haʻi mua i kāu kauka.)
• ʻO ka poʻe i loaʻa mua i ka angioedema (ka pehu ʻana o ka maka).
• ʻO nā kānaka me ka maʻi puʻupaʻa koʻikoʻi a i ʻole ka stenosis o ke aʻa renal.

Nā pilina me nā lāʻau lapaʻau ʻē aʻe

Inā ʻoe e lawe ana i kahi ACE inhibitor, he mea nui e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei (ʻoiai nā huaora).

• Nā lāʻau hoʻopau ʻeha (NSAID): Inā hoʻohana pinepine ʻia nā lāʻau hoʻopau ʻeha e like me Ibuprofen lāua ʻo Diclofenac, hiki iā lākou ke hōʻemi i ka pono o nā mea hoʻopaʻa ACE a hoʻopilikia i nā puʻupaʻa.
• Nā lāʻau lapaʻau e hoʻopilikia ai i nā pae potassium: Hiki i kekahi mau lāʻau lapaʻau ke hoʻonui i nā pae potassium i ke kino me ke kumu ʻole (hyperkalemia).
• Paʻakai a me nā pani paʻakai: E kūkākūkā me kāu kauka e pili ana i ka nui o ka paʻakai āu e ʻai ai. Eia kekahi, e ʻoluʻolu e nīnau i kāu kauka ma mua o ka hoʻohana ʻana i nā "pani paʻakai" i loaʻa ka potassium.

Āhea ʻoe e ʻimi koke ai i ke aʻo lapaʻau?

Inā loaʻa kekahi o nā hōʻailona koʻikoʻi ma lalo nei, e hele koke i ka haukapila Emergency Department (ETU) kokoke loa.

Inā ʻoe e lawe ana i kahi ACE inhibitor, e kauoha paha kāu kauka i kekahi mau hoʻāʻo koko a me ka mimi ma ka liʻiliʻi i hoʻokahi manawa i ka makahiki e nānā i kāu hana puʻupaʻa a me nā pae paʻakai koko. He mea nui loa ia ʻaʻole e haʻalele i kēia mau hoʻāʻo.