ʻElua ʻano lāʻau lapaʻau e pale ai i nā ʻūpā koko? E kamaʻilio kākou e pili ana i ka Dual Antiplatelet Therapy (DAPT)

Ua loaʻa anei iā ʻoe kahi hōʻeha puʻuwai, a i ʻole ua hoʻokomo ʻia kahi stent, a i ʻole ke ʻoki bypass paha, a ua kuhikuhi kāu kauka iā ʻoe e lawe i ʻelua mau lāʻau lapaʻau i ka manawa hoʻokahi? Nui ka poʻe e hopohopo iki nei no kēia. He mea maʻamau ka noʻonoʻo ʻana i nā nīnau e like me "No ke aha i hāʻawi ʻia mai ai iaʻu ʻelua mau lāʻau lapaʻau?" a "E hoʻopilikia anei kēia?". No laila, i kēia lā e kamaʻilio mākou e pili ana i kēia ʻano lapaʻau lāʻau, ʻo ia hoʻi ʻo Dual Antiplatelet Therapy (DAPT).

I ka ʻōlelo maʻalahi, he aha ka DAPT?

He hui pū ʻia ka DAPT e hoʻohana ana i ʻelua ʻano lāʻau hoʻokahe koko. ʻO ke kikoʻī, hāʻawi ʻia ʻoe i ka aspirin me kekahi lāʻau ʻē aʻe i kapa ʻia he mea hoʻopaʻa P2Y12 .

E nānā, i ka wā e ʻeha ai mākou ma kekahi wahi o ko mākou kino, e pau ke kahe ʻana o ke koko no ka mea e paʻa ana ke koko a pani ʻia ka ʻeha. He mea maikaʻi kēlā. Akā, he aha ka mea e hana ʻia inā e hana ʻia nā paʻa koko i loko o ko mākou mau kīʻaha koko me ke kumu ʻole? E noʻonoʻo i kahi pilikia kaʻa ma ke alanui, e like me nā kaʻa i hoʻopaʻa ʻia, hiki i kēia mau paʻa koko ke paʻa i loko o ko mākou mau kīʻaha koko. Inā paʻa kēlā ʻano paʻa koko i loko o kahi kīʻaha koko e alakaʻi ana i ka puʻuwai, hiki mai kahi hāʻule puʻuwai. Inā paʻa ia i loko o kahi kīʻaha koko e alakaʻi ana i ka lolo, hiki mai kahi hahau.

No laila, ʻo ka hana a kēia lāʻau DAPT, ʻo ia ke pale ʻana i nā platelets, nā ʻāpana liʻiliʻi i loko o ko kākou koko, mai ka pipili pū ʻana a me ke kāpili ʻana. Ma kēia ʻano, hiki i kēia lāʻau ke hoʻōki i ka hoʻokumu ʻia ʻana o nā ʻōpū koko weliweli (Thrombosis).

ʻO wai ka mea e pono ai ka mālama ʻana o DAPT?

ʻO ka maʻamau, kuhikuhi nā kauka i kēia lāʻau lapaʻau ma hope o kahi hanana olakino a no ka poʻe i pilikia i ka loaʻa hou ʻana o ia mea. E nānā i ka papa ma lalo.

He aha nā pōmaikaʻi a me nā pilikia o ka mālama ʻana iā DAPT?

E like me nā lāʻau lapaʻau āpau, loaʻa i kēia kekahi mau pōmaikaʻi a me kekahi mau pilikia.

• ʻO ka pōmaikaʻi nui: Ma ka pale ʻana i nā ʻūpā koko, ua emi nui ka pilikia o ka loaʻa ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau. He lāʻau lapaʻau kēia e hoʻōla ai i ke ola, ʻoiai no ka mea i kau ʻia kahi stent.

• Ka pilikia nui: Ma muli o ka pale ʻana o kēia mau lāʻau lapaʻau i ke kāpili ʻana o ke koko, aia ka pilikia o ke kahe ʻana o ke koko.
• ʻO ka hōʻailona maʻamau ka kahe koko gastrointestinal .
• ʻOiai kahi ʻeha liʻiliʻi a ʻoki paha hiki ke hoʻonui i ke kahe koko ma mua o ka mea maʻamau.
• He mea kākaʻikahi loa, hiki ke loaʻa nā maʻi koʻikoʻi e like me ke kahe ʻana o ke koko i loko o ka lolo.

Nā hopena ʻaoʻao a me nā pilikia me nā lāʻau lapaʻau ʻē aʻe

Nā hopena ʻaoʻao i ʻike pinepine ʻia

Hiki i kekahi poʻe ke loaʻa i kēia mau mea i ka wā e lawe ana i kēia lāʻau lapaʻau:

• Paʻakikī ka hanu ʻana
• Ke koko i loko o ka mimi (Hematuria)
• ʻO ka ʻeha ma ke kino i wehewehe ʻole ʻia
• Kahe koko ihu (Epistaxis)
• Ka emi ʻana o ka helu platelet i loko o ke koko (Thrombocytopenia)
• Nā polyps ihu

Inā hoʻomau kēia, e kamaʻilio me kāu kauka.

Nā lāʻau ʻē aʻe e launa pū me kēia lāʻau lapaʻau

Inā ʻoe e lawe ana i ka DAPT, pono ʻoe e makaʻala loa i ka lawe ʻana i nā lāʻau lapaʻau ʻē aʻe, ʻoiai kēia mau mea:

• Nā Anticoagulants (nā lāʻau hoʻokahe koko ʻē aʻe):Nā lāʻau lapaʻau e like me Warfarin lāua ʻo Apixaban. Inā e lawe pū ʻia kēia mau mea, ʻoi aku ka nui o ka pilikia o ke kahe ʻana o ke koko.
• Nā NSAID (nā lāʻau hoʻopau ʻeha): Nā lāʻau lapaʻau e like me Ibuprofen, Diclofenac, a me Mefenamic Acid a mākou e lawe pinepine ai no nā ʻeha poʻo a me nā ʻeha kino. Hoʻonui kēia i ka pilikia o ke kahe ʻana o ke koko i ka wā e hui pū ʻia me DAPT.
• Nā Antidepressants: Lawe ʻia kekahi mau lāʻau lapaʻau no ke kaumaha.
• Nā mea pale o ka pamu proton (PPI): Nā lāʻau lapaʻau e like me Omeprazole a mākou e hoʻohana pinepine ai no ka gastritis.

Pehea ka lōʻihi e pono ai ke lawe ʻia ka DAPT?

ʻAʻole like kēia no nā kānaka a pau. Na kāu kauka e hoʻoholo i ka lōʻihi o kou pono ʻana i ka DAPT. Aia kekahi mau kumu e hoʻopilikia ai i kēia:

• Kou makahiki a me kou olakino holoʻokoʻa.
• He aha kou pilikia o ke kahe ʻana o ke koko?
• ʻO ka pilikia o ka loaʻa hou ʻana o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana.
• ʻO ke kumu no ka hoʻomaka ʻana o DAPT ma kahi mua (ma muli o kahi stent? ma muli o ka hōʻeha puʻuwai?).

ʻOiai paha e pono ana kekahi poʻe i kēia lāʻau lapaʻau no hoʻokahi a ʻelua paha mahina, nui paha nā poʻe ʻē aʻe e pono ai no hoʻokahi makahiki a ʻoi aku paha . Hiki i kāu kauka ke ʻōlelo aku iā ʻoe e lawe wale i ka aspirin no ke koena o kou ola, ʻoiai ma hope o ka hoʻōki ʻana i ka DAPT.

I ka manawa e ʻimi koke ai i ke aʻo lapaʻau

Ma muli o ka pilikia o ke kahe ʻana o ke koko o kekahi e lawe ana i ka DAPT, pono ʻoe e makaʻala loa i nā hōʻailona ma lalo nei. Inā loaʻa iā ʻoe kekahi o kēia mau mea, e ʻike koke i ke kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.