Ua loaʻa anei iā ʻoe kahi hōʻeha puʻuwai i hala koke aku nei? A i ʻole ua kau ʻia kahi stent i loko o kahi aʻa i loko o kou puʻuwai? Ua kuhikuhi paha kāu kauka iā ʻoe i ʻelua ʻano lāʻau lapaʻau. ʻO kekahi paha he aspirin. ʻO kekahi paha he pila me kahi inoa ʻē aʻe. No laila ke noʻonoʻo nei paha ʻoe, "No ke aha i hāʻawi ʻia ai iaʻu ʻelua mau lāʻau lapaʻau like ʻole no ke kūlana like?" He nīnau kēia a ka poʻe he nui. I kēia lā, ke kamaʻilio nei mākou e pili ana i ka DAPT, a i ʻole Dual Antiplatelet Therapy, he lāʻau lapaʻau koʻikoʻi ia e hoʻōla ola ai no ka hapa nui o ʻoukou.
He aha ka DAPT? E hoʻomaopopo maʻalahi kākou.
I mea e hoʻomaopopo ai i kēia, pono mua kākou e ʻike iki e pili ana i ko kākou koko. Loaʻa i loko o ko kākou koko nā hunaola koko ʻulaʻula, nā hunaola koko keʻokeʻo, a me nā ʻāpana liʻiliʻi ʻē aʻe o nā hunaola. Ua kapa ʻia kēia mau mea
he platelets . ʻO ka hana nui o kēia
mau platelets , ʻo ia ke hoʻōki i ke kahe ʻana o ke koko ke loaʻa kahi ʻeha ma kekahi wahi o ko kākou kino, a holo wikiwiki lākou i kahi, pili pū, a hana i kahi ʻupena e hoʻōki ai i ke kahe ʻana o ke koko. Ua like ia me ke kau wikiwiki ʻana i kahi palaki ma kahi paipu haʻihaʻi. ʻO kēia ka mea a kākou e kapa nei
he clotting koko . He hana nui kēia no ka hoʻopakele ʻana i ko kākou ola. Eia naʻe, hoʻomaka ka pilikia ma kahi i manaʻo ʻole ʻia ai kēia clotting koko, ʻo ia hoʻi, inā hana ia i loko o kekahi o ko kākou mau kīʻaha koko. E noʻonoʻo i ka mea e hana ʻia inā hana ʻia kahi clot koko i loko o kahi aa koko e lawe ana i ke koko i ka puʻuwai? Ua ālai ʻia kēlā kīʻaha koko, e hoʻōki ana i ke kahe ʻana o ke koko i ka puʻuwai a hoʻoulu
i ka hōʻeha puʻuwai (Myocardial Infarction) . Eia kekahi, inā hele kēia clot koko i ka lolo, hiki iā ia ke hana
i ka hahau . No laila,
ʻo Dual Antiplatelet Therapy (DAPT) kahi lāʻau lapaʻau e hoʻōki ai i kēlā mau clots koko weliweli mai ka hana ʻana i loko o nā aa koko. Ma kēia, ua hāʻawi pū ʻia nā ʻano lāʻau ʻelua i kapa ʻia ʻo
"Antiplatelet" . ʻO Antiplatelet kahi lāʻau e pale ai i ka pipili ʻana o nā platelets, ʻo ia hoʻi ke pale nei i ka hoʻokumu ʻana o nā ʻūpā koko. ʻO "Dual" ke ʻano o ʻelua. No laila, ua kapa ʻia kēia ʻo Dual Antiplatelet Therapy no ka mea ua hāʻawi pū ʻia nā ʻano lāʻau ʻelua.
I ka ʻōlelo maʻalahi, ʻo DAPT ka hui pū ʻana o ʻelua mau lāʻau lapaʻau e pale ai i ke kūkulu ʻia ʻana o nā ʻōpū koko i makemake ʻole ʻia i loko o ko mākou mau kīʻaha koko .
ʻO wai ka mea e pono ai kēia lāʻau DAPT?
ʻAʻole hāʻawi nā kauka i kēia lāʻau i nā kānaka a pau. Hāʻawi wale ʻia ia i ka poʻe i loaʻa i ka pilikia nui o ka loaʻa ʻana o nā ʻūpā koko i loko o ko lākou mau aa koko. Hoʻomaʻamaʻa pinepine ʻia kēia lāʻau i nā hihia aʻe:
| I ka wā e pono ai ka lāʻau lapaʻau | He wehewehe maʻalahi |
|---|
| Ma hope o ka hāʻule ʻana o ka puʻuwai | He mea nui loa kēia e pale aku ai i ke kūkulu ʻia ʻana o kekahi ʻaʻa koko ʻē aʻe a me ke kumu ʻana o kahi hāʻule puʻuwai hou i loko o kekahi mea i loaʻa i ka hāʻule puʻuwai. |
| Ma hope o ka hahau ʻana a i ʻole TIA | Hāʻawi ʻia kēia lāʻau lapaʻau e pale aku i ka hoʻi hou ʻana o ka hahau ma hope o ka hahau i hana ʻia e ke koko i loko o kahi kīʻaha koko i loko o ka lolo. ʻO ka TIA (Transient Ischemic Attack) he ʻano like ia me ka mini-stroke. |
| Ma hope o ke kau ʻana o ka stent | He ʻōmole ʻupena liʻiliʻi ka stent i hoʻokomo ʻia i loko o kahi kīʻaha koko i paʻa i loko o ka puʻuwai e wehe mau ai. Nui ka pilikia o ka hoʻokumu ʻia ʻana o nā ʻōpū koko i loko o kēia stent. Pono loa ka DAPT e pale aku i kēia. |
| Ma hope o ka Angioplasty | ʻO kēia ka hoʻonui ʻana i ke kīʻaha koko i paʻa ʻia ma ka hoʻopiha ʻana i kahi mea e like me ka pōpō. Aia nō ka pilikia o ka hoʻokumu ʻia ʻana o nā ʻōpū koko ma hope o kēia. |
| Ma hope o ke ʻoki ʻana i ke aʻa coronary bypass | ʻOiai ma hope o kēia ʻoki kino, kahi e kāpae ai i nā aʻa koko i ālai ʻia i loko o ka puʻuwai a hoʻoili i nā kīʻaha koko hou, aia kekahi mau manawa e hāʻawi ʻia ai kēia lāʻau lapaʻau e pale aku i ke kūkulu ʻia ʻana o nā ʻaʻa koko i loko o kēlā mau aʻa koko hou. |
He aha nā lāʻau lapaʻau i hāʻawi ʻia no DAPT?
Ke ʻōlelo nei mākou ua hāʻawi pū ʻia nā ʻano lāʻau ʻelua i ka mālama ʻana iā DAPT. ʻO kēlā mau ʻano lāʻau ʻelua: 1.
ʻAspirin: He lāʻau kēia i lohe ʻia e ka poʻe he nui o ʻoukou. ʻOiai ua hoʻohana pinepine ʻia ia i nā dosis kiʻekiʻe e like me ka mea hoʻopau ʻeha, hāʻawi ʻia ia i nā dosis haʻahaʻa loa e pale aku i nā ʻōpū koko i nā maʻi puʻuwai. 2.
He lāʻau lapaʻau i loko o ka hui P2Y12 Inhibitor: ʻO kēia ka lua o ka lāʻau. Aia kekahi mau ʻano lāʻau lapaʻau e pili ana i kēia hui.
- ʻO Clopidogrel
- ʻO Prasugrel
- ʻO Ticagrelor
Na kāu kauka e hoʻoholo i kahi o kēia mau lāʻau lapaʻau ʻekolu e hāʻawi iā ʻoe a me ke ʻano o ka nui.Aia ia i nā kumu he nui, e like me kou kūlana olakino, ka makahiki, a inā he mau kūlana olakino ʻē aʻe kou.
He aha nā pōmaikaʻi a me nā pilikia o ka mālama ʻana iā DAPT?
E like me nā lāʻau lapaʻau a pau, loaʻa i ka lāʻau lapaʻau DAPT nā pono a me kekahi mau pilikia. He mea nui e makaʻala i nā mea ʻelua.
| Pōmaikaʻi nui | Pōpilikia Nui |
|---|
| Ke hoʻopakele nei i nā ola: Ma ka pale ʻana i nā ʻūpā koko mai ka hoʻokumu ʻana i loko o nā kīʻaha koko, ua emi nui ka pilikia o nā hōʻeha puʻuwai a me nā hahau. ʻO kēia ka pōmaikaʻi nui loa a koʻikoʻi loa o kēia lāʻau lapaʻau. | Ka pilikia o ke kahe koko: No ka mea, pale kēia mau lāʻau lapaʻau i ka hoʻokumu ʻana o nā ʻūpā koko, hiki ke hoʻopaneʻe ʻia ma nā wahi i hana mau ʻia ai nā ʻūpā koko a hoʻōki i ke kahe koko. Hiki i kēia ke hoʻonui i ka pilikia o ke kahe koko ma mua o ka maʻamau . |
ʻOi aku ka nui e pili ana i ka pilikia o ke kahe ʻana o ke koko ...
Mai makaʻu ke lohe ʻoe i ka "pilikia o ke kahe ʻana o ke koko." Hiki i kēia ke ʻano i nā mea liʻiliʻi a hiki i nā mea koʻikoʻi.
- Ke kahe koko iki: ʻO ke kahe ʻana o nā ʻāʻī i ka wā e palaki ai i kou mau niho, ke kahe ʻana o ka ihu, a me ka polū koke ʻana ma hope o kahi ʻeha liʻiliʻi he mea maʻamau.
- Ke kahe koko nui: ʻOiai he mea kakaikahi loa, hiki ke kahe koko i loko o ka ʻōpū a i ʻole nā naʻau (Gastrointestinal bleeding ). Hiki i kēia ke hana i ke koko i loko o ka ʻōpala a i ʻole e hoʻolilo i ka ʻōpala i ʻeleʻele. ʻOi aku ka kakaikahi, hiki ke kahe koko i loko o ka lolo .
ʻO ka mea nui, ʻo ia ke hāʻawi nei kāu kauka iā ʻoe i kēia lāʻau lapaʻau no ka mea ua loiloi ʻo ia he ʻoi aku ka nui o ka pilikia o ke koko ma mua o ka pilikia o ke kahe ʻana o ke koko. No laila, he mea nui e hahai i nā ʻōlelo a kāu kauka.
Nā hopena ʻaoʻao a me nā pilina me nā lāʻau lapaʻau ʻē aʻe
Hiki i kekahi poʻe e lawe ana i ka DAPT ke loaʻa nā hopena ʻaoʻao liʻiliʻi.
Eia kekahi, i ka wā e lawe ai i ka DAPT, pono ʻoe e hoʻomaopopo i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei. No ka mea hiki i kekahi mau lāʻau lapaʻau ke hoʻopilikia i ka pono o DAPT. E akahele loa me kēia mau lāʻau lapaʻau.
- Nā lāʻau lapaʻau ʻē aʻe e hoʻokahe koko ( Anticoagulants ): Inā ʻoe e lawe ana i nā lāʻau lapaʻau e like me Warfarin, ʻoi aku ka nui o ka pilikia o ke kahe ʻana o ke koko.
- Nā lāʻau hoʻopau ʻeha (NSAID): ʻO ka hoʻohana pinepine ʻana i nā lāʻau lapaʻau e like me Ibuprofen lāua ʻo Diclofenac e hoʻonui i ka pilikia o ke kahe ʻana o ke koko o ka ʻōpū.
- Kekahi mau lāʻau lapaʻau no ke kaumaha (Antidepressants).
- Nā lāʻau lapaʻau no ka gastritis (Proton Pump Inhibitors): Nā lāʻau lapaʻau e like me Omeprazole.
No laila, mai poina
e haʻi i kāu kauka e pili ana i nā mea āpau āu e lawe ai, me nā pila, nā huaora, a me nā lāʻau lapaʻau kuʻuna.
Pehea ka lōʻihi e pono ai iaʻu e lawe i kēia lāʻau lapaʻau?
He pilikia nō hoʻi kēia no nā poʻe he nui. ʻAʻole like ka lōʻihi o ka lawe ʻana i ka DAPT no kēlā me kēia kanaka. He ʻokoʻa ia mai kēlā kanaka a kēia kanaka.
- Hiki i kekahi poʻe ke hāʻawi iā ia no ka manawa pōkole, e like me hoʻokahi a ʻelua paha mahina.
- He nui ka poʻe e inu ana no hoʻokahi makahiki a ʻoi aku paha.
- ʻOiai ma hope o ka hoʻōki ʻana i ka mālama ʻana iā DAPT, hiki i kāu kauka ke haʻi iā ʻoe e lawe wale i ka aspirin no ke koena o kou ola.
Hoʻoholo ʻia kēia manawa e kāu kauka. Aia kekahi mau kumu e hoʻopilikia ai:
- He aha ke kumu i hoʻomaka ʻia ai ʻoe ma DAPT (he hōʻeha puʻuwai? No ka mea ua kau ʻia kahi stent?).
- Kou makahiki a me kou olakino holoʻokoʻa.
- ʻEhia ka nui o ka pilikia o ke kahe ʻana o ke koko?
- ʻO ka pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana i ka wā e hiki mai ana.
He aha kāu e hana ai e pale iā ʻoe iho i ka wā e lawe ana iā DAPT?
Pono hoʻi ʻoe e noʻonoʻo i kou palekana i ka wā e hana ʻia ai kēia lāʻau lapaʻau. Eia kekahi mau mea maʻalahi hiki iā ʻoe ke hana e kōkua.
- E lawe i kāu lāʻau lapaʻau i ka manawa kūpono: E lawe i kāu lāʻau lapaʻau e like me ka ʻōlelo a kāu kauka iā ʻoe, me ka ʻole o ka haʻalele ʻana i kekahi lā . Inā ʻoe e poina i kahi mahele lāʻau, hiki ke hana i kahi ʻūpā koko. Mai hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau me ka ʻole o ke nīnau ʻana i kāu kauka.
- E komo i kahi kāleka ID lapaʻau:Inā hiki, e lawe mau i kahi kūpeʻe lima a kāleka paha e ʻōlelo ana e lawe ana ʻoe i ka DAPT. I ka wā o kahi pilikia, e kōkua kēia i ka poʻe e mālama nei iā ʻoe e ʻike e lawe ana ʻoe i nā lāʻau hoʻokahe koko.
- E haʻi aku i kāu mau kauka a pau: ʻOiai inā e ʻike ʻoe i ke kauka niho a i ʻole e hana i kekahi ʻoki ʻē aʻe, pono ʻoe e haʻi iā lākou e lawe ana ʻoe i ka DAPT, no ka mea, koi kekahi mau ʻoki ʻana iā ʻoe e hoʻōki i ka lawe ʻana i kēia lāʻau lapaʻau no kekahi manawa.
He aha nā hōʻailona e pono ai ke kōkua koke ʻia e ke kauka?
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, he hōʻailona paha ia o ke kahe koko nui. No laila, mai hoʻokaʻulua a
kāhea koke aku i kāu kauka a i ʻole
e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa. Nā hōʻailona koko e pono ai ka mālama koke
| ⚫ | Nā ʻōpala ʻeleʻele a koko paha. |
| 🤮 | Ka luaʻi ʻana i ke koko (e like me ke kofe lepo a i ʻole ke kala ʻulaʻula/ʻeleʻele). |
| 🤕 | ʻEha poʻo koʻikoʻi loa, koke koke |
| 😵 | Pōniuniu , manaʻo e like me ka nalowale ʻana o ka ʻike. |
| 😖 | ʻEha nui o ka ʻōpū . |
| ❓ | Ka huikau . |
| 😮💨 | Ka paʻakikī o ka hanu ʻana a i ʻole ka ʻeha o ka umauma. |
Eia kekahi, inā manaʻo ʻoe ua lawe nui ʻoe i ka lāʻau lapaʻau, e kāhea koke i kāu kauka. A i ʻole,Hiki iā ʻoe ke kelepona
i ke Kikowaena ʻIke Lāʻau Lapaʻau Lahui ma ka Halemai Lahui ʻo Colombo no ka ʻōlelo aʻoaʻo.
Leka Lawe-Home
- ʻO DAPT ka hui pū ʻana o ʻelua mau lāʻau lapaʻau e pale ai i nā ʻūpā koko. He lāʻau lapaʻau hoʻōla ola kēia e pale aku iā ʻoe mai nā maʻi koʻikoʻi e like me nā hōʻeha puʻuwai a me nā hahau.
- ʻO ka pilikia nui o kēia lāʻau lapaʻau, ʻo ia ka hoʻonui ʻia ʻana o ke kahe koko, no laila hiki i kahi ʻeha liʻiliʻi ke lōʻihi ka manawa e hoʻōki ai i ke kahe koko.
- E lawe i ka lāʻau lapaʻau e like me ke kauoha a kāu kauka, me ka ʻole e hoʻokuʻu i hoʻokahi lā. Mai hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau no kekahi kumu me ke kūkākūkā ʻole me kāu kauka.
- E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau ʻē aʻe āu e lawe nei. Eia kekahi, e haʻi i kāu kauka inā ʻoe e ʻike i ke kauka niho a i ʻole e hana i kekahi ʻoki ʻē aʻe.
- Inā he ʻeleʻele kou mau ʻōpala, luaʻi koko, a i ʻole he ʻeha poʻo nui, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila.
DAPT, Dual Antiplatelet Therapy, ke koko ʻana, ka hōʻeha puʻuwai, ka hahau ʻana, stent, aspirin, clopidogrel, Clopidogrel, maʻi puʻuwai, nā lāʻau hoʻomāmā koko
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