Ua hele mai ʻo Nihal (58 makahiki) i koʻu keʻena lapaʻau i ka pule i hala me ka manaʻo hopohopo a me ka luhi. ʻAʻohe ona moʻolelo o ka maʻi puʻupaʻa, akā ua hōʻike nā hoʻokolohua koko ua hāʻule koke kona mau puʻupaʻa ʻelua.
"E Kauka Priya, lawe mau wau iā Losartan a me kahi diuretic i kēlā me kēia lā, ka mea a ke kauka i kuhikuhi ai no ke koko kiʻekiʻe a me nā maʻi puʻuwai. I kēia mau lā iho nei, ma muli o ka ʻeha nui ma koʻu poʻohiwi, ua kūʻai au i nā papa Diclofenac mai kahi hale kūʻai lāʻau lapaʻau me ke kauoha ʻole a ke kauka a hoʻomau i ka lawe ʻana iā lākou no kekahi mau pule. I kēia manawa ua pehu koʻu mau wāwae ʻelua a ua paʻakikī iaʻu ka hanu ʻana," wahi a Nihal.
Ua haʻi mālie aku au iā Nihal, "E Nihal, ua hana ʻoe i kahi hewa weliweli me ka ʻike ʻole. Ma ka lawe ʻana i kēia lāʻau hoʻopau ʻeha e like me ka diclofenac me nā pila koko a me nā pila wai āu e lawe nei, ua aneane pau ke kahe ʻana o ke koko i nā puʻupaʻa. I ka lāʻau lapaʻau, kapa mākou i kēia he triple whammy . Ua hōʻeha nui kēia i kou mau puʻupaʻa. E kamaʻilio kākou e pili ana i kēia i kēia lā i ʻike ai nā mea a pau."
🚨 Nā Hōʻailona ʻUlaʻula o ka Hāʻule ʻana o ka Puʻupaʻa e Pono e Hoʻāla i ka Lāʻau Lapaʻau
Inā ʻike ʻoe i nā hōʻailona ma lalo nei i ka wā e hoʻohana ana i nā lāʻau ʻeha me ke kauoha ʻole a ke kauka, pono ʻoe e ʻimi koke i ke kōkua lapaʻau no ka mea he hōʻailona paha ia o ka hāʻule ʻana o ka puʻupaʻa:
- Ka pehu koke ʻana o nā wāwae, nā kuʻekuʻe wāwae, nā wāwae, a i ʻole ka maka (Paʻa ʻana o ka wai).
- Ka pōkole nui o ka hanu me ke kumu ʻike ʻole ʻia.
- Manaʻo i ka luhi loa, ka palaualelo, a i ʻole ke ola ʻole.
- Ka emi koke ʻana o ka nui o ka mimi i hoʻopuka ʻia i kahi pae haʻahaʻa loa (a i ʻole ʻaʻohe mimi i hoʻopuka ʻia).
ʻO ka pōʻino leo ʻole o nā lāʻau ʻeha NSAID
He nui ka poʻe ma Sri Lanka e kūʻai pololei ana i nā NSAID (Non-Steroidal Anti-Inflammatory Drugs) mai nā hale kūʻai lāʻau lapaʻau ke loaʻa iā lākou ka ʻeha kino, ka ʻeha poʻo, a i ʻole ka ʻeha ʻiʻo.
ʻO nā hiʻohiʻona nui:
- ʻO Diclofenac
- ʻAspirina
- ʻIbuprofen
- ʻAkika Mefenamic / Ponstan
ʻOiai hiki i kēia mau lāʻau ke hōʻoluʻolu i ka ʻeha no kekahi manawa, hiki i ka hoʻohana mau ʻana ke hoʻopilikia mau i ka hana o nā puʻupaʻa. Kiʻekiʻe loa ka pilikia ke lawe ʻia kēia mau lāʻau me nā lāʻau ʻē aʻe i hoʻohana ʻia no ke koko a me nā maʻi puʻuwai.
He aha ka "Triple Whammy" o ka hāʻule ʻana o ka puʻupaʻa?
Hiki i nā maʻi e mālama ʻia ana no ke koko kiʻekiʻe a me ka maʻi puʻuwai ke hoʻohana pū me ka ʻike ʻole i nā papa lāʻau ʻekolu e hiki mai ana, e hoʻopau loa ana i ke kaʻina kānana o ka puʻupaʻa. Ua ʻike ʻia kēia ma nā ʻōlelo lapaʻau ʻo "Triple Whammy":
1.Nā mea hoʻopaʻa ACE a i ʻole ARB: ʻO nā lāʻau lapaʻau e like me Captopril , Enalapril , a i ʻole Losartan, a nā kauka i kuhikuhi ai e hoʻohaʻahaʻa i ke koko, hoʻonui i nā arterioles efferent e lawe ana i ke koko mai nā puʻupaʻa a hoʻemi i ke kaomi i loko o nā puʻupaʻa.
2. Diuretics (nā pila wai): Nā lāʻau lapaʻau e kōkua i ke kino e hoʻopau i ka paʻakai a me ka wai keu ma o ka mimi, kahi e hoʻemi ai i ka nui o ke koko e kahe ana i nā puʻupaʻa.
3. Nā lāʻau hoʻomaha ʻeha NSAID (Diclofenac/Aspirin): Ke ālai nei kēia mau lāʻau hoʻomaha ʻeha i ka hana ʻana o nā prostaglandins, ka mea e kōkua ai i ka hoʻonui ʻana i nā kīʻaha koko i loko o nā puʻupaʻa. ʻO kēia ke kumu e emi nui ai nā arterioles afferent.
Ke hana ʻia kēia mau hana ʻekolu i ka manawa like, e hāʻule nui ana ka nui o ke koko e kahe ana i ka puʻupaʻa, e nalowale ana ke kaomi kānana, a hiki mai ka ʻeha puʻupaʻa koʻikoʻi (AKI) .
ʻO ka pilikia o ke kūʻai ʻana i nā lāʻau lapaʻau ma nā hale kūʻai lāʻau lapaʻau ma ke ʻano wikiwiki
ʻO nā limahana o nā hale kūʻai lāʻau lapaʻau, ʻaʻole nā kauka e hiki ke ʻike i nā maʻi. No ka mea, ʻaʻole lākou i ʻike i nā lāʻau lapaʻau lōʻihi āu e lawe nei, ʻo ka hāʻawi ʻana iā ʻoe i nā lāʻau ʻeha āu e noi nei hiki ke hana i nā pilina lāʻau make e like me kēia.
Hoʻohana ka poʻe he nui ma Sri Lanka i nā lāʻau ʻeha maʻalahi no ka manawa lōʻihi me ka ʻole o ka maopopo ʻana i ko lākou mau hopena koʻikoʻi.
Nā mea e pono ai a me nā mea ʻaʻole e pono ai
| ✔️ Nā mea e hana ai (Hana) | ❌ Nā mea pono ʻole |
|---|---|
| Inā ʻoe e lawe i nā lāʻau koko a i ʻole nā lāʻau wai, e noi i kāu kauka no ka ʻōlelo aʻo a e hoʻohana wale i kahi lāʻau palekana e like me ka paracetamol inā loaʻa ka ʻeha. | Mai kūʻai pololei i nā lāʻau ʻeha e like me diclofenac, ibuprofen, a i ʻole aspirin mai nā hale kūʻai lāʻau lapaʻau a hoʻomau i ka lawe ʻana iā lākou me ke kauoha ʻole a ke kauka. |
| E hana i kahi hoʻāʻo koko maʻalahi (Serum Creatinine/eGFR) ma ka liʻiliʻi i hoʻokahi manawa i ka makahiki e nānā i ka hana o nā puʻupaʻa. | Mai hoʻohana i nā lāʻau hoʻomaha ʻeha NSAID ke loaʻa iā ʻoe ke kuni a i ʻole ua maloʻo kou kino. |
| E hōʻike i nā kikoʻī o nā lāʻau lapaʻau lōʻihi āu e lawe nei i kāu kauka i kēlā me kēia manawa āu e ʻike ai iā ia. | ʻOiai ʻaʻole paha e hōʻike ʻia nā hōʻailona o ka hōʻino ʻana o ka puʻupaʻa i nā pae mua, mai kali a hiki i kou maʻi ʻana e ʻimi i ke kōkua lapaʻau. |
❓ Kekahi mau nīnau ʻē aʻe āu e loaʻa ai (FAQ)
ʻO wai nā maʻi i pilikia no ka "Triple Whammy"? ▼
He kiʻekiʻe loa kēia pilikia i nā poʻe maʻi e lawe ana i nā ACE inhibitors/ARBs a me nā diuretics (nā pila wai) no ke koko kiʻekiʻe, maʻi puʻuwai, a i ʻole ka hāʻule ʻana o nā puʻupaʻa, a ke lawe nei hoʻi i nā lāʻau ʻeha (NSAIDs).
Pono anei au i ka dialysis inā loaʻa iaʻu ka hāʻule ʻana o ka puʻupaʻa ma muli o ka lawe ʻana i nā lāʻau ʻeha ?
Inā loaʻa kahi ʻeha koʻikoʻi o ka puʻupaʻa, pono paha ka dialysis no kekahi manawa no ka kaohi ʻana i nā mea ʻawahia i loko o ke kino. I ka manawa pinepine, me ka hoʻōki koke ʻana i nā lāʻau ʻeha a me ka mālama pono ʻana i nā lāʻau lapaʻau, hiki i nā puʻupaʻa ke hoʻōla i loko o kekahi mau pule.
Ke hōʻino nei anei ka hoʻohana ʻana iā Paracetamol i nā puʻupaʻa ?
ʻAʻole, palekana loa ka paracetamol no nā puʻupaʻa ke lawe ʻia i ka nui i ʻōlelo ʻia (ʻaʻole i ʻoi aku ma mua o 4g i kēlā me kēia lā). ʻOiai ʻaʻole he NSAID ka paracetamol, ʻaʻole ia e hoʻopilikia i ke kahe koko i nā puʻupaʻa.
He aha nā "Nā Rula o ka Lā Maʻi"? ▼
I nā lā e loaʻa ai iā ʻoe ka maʻi pākī nui, ka luaʻi ʻana, a i ʻole ke kuni nui a maloʻo loa, pono e hoʻōki ʻia nā lāʻau lapaʻau e like me ACE inhibitors, ARBs, diuretics, a me NSAIDs no kekahi mau lā ma lalo o ke aʻo ʻana a ke kauka e pale i nā puʻupaʻa, ʻoiai ua emi ke kahe o ke koko i nā puʻupaʻa.
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