Na nɔmal tin fɔ mek yu fil bad bad wan ɛn wɔri we di dɔktɔ tɛl yu se yu at wik, ɔ lɛk aw wi kin kɔl am, yu gɛt at prɔblɛm. Yu no aw i nɔ kin izi fɔ liv wit prɔblɛm dɛn lɛk we yu taya, yu fut kin swel, ɛn yu nɔ kin ebul fɔ slip fayn na nɛt ivin afta yu dɔn tray smɔl. Sɔm tɛm de wae de sayd ɛfɛkt lɛk kɔf wae kin kam wit sɔm pan de ol mɛrɛsin wae dɛn kin gi fɔ dis sik kin mek yu fil bad mɔr. Bɔt we di sayɛns bɔt mɛrɛsin dɔn go bifo, di tritmɛnt dɛn we rili fayn ɛn nyu tritmɛnt dɛn dɔn kam na do naw fɔ dɛn kayn sik ya. Wan pan dɛn kayn nyu klas fɔ drɔgs we dɔn mek bɔku pipul dɛn fil fayn na ARNI. Lɛ wi tɔk bɔt dis jɔs tide.
Fɔ tɔk am simpul wan, wetin na ARNI?
Pan ɔl we di nem ARNI kin tan lɛk se i kɔmplikt smɔl, di minin we i gɛt rili simpul. ARNI (Angiotensin Receptor/Neprilysin Inhibitor) na spɛshal mɛrɛsin we dɛn kin mek bay we dɛn jɔyn tu kayn mɛrɛsin fɔ trit at prɔblɛm. Lɛk tu atlet dɛn we gɛt sɛns we de ple togɛda na di sem tim, dɛn tu drɔgs ya de wok togɛda fɔ mek yu at rili fil fayn.
Dɛn tu mɛrɛsin ya na:
1. ARB (Angiotensin II Receptor Blocker): Di nem fɔ dis na Valsartan.
2. Neprilysin Inhibitor: Di nem fɔ dis na Sacubitril.
Naw, di wangren ARNI drɔg we dɛn de yuz na Sri Lanka ɛn di wɔl na Sacubitril/Valsartan . Dɛn bin gri fɔ dis insay 2015.
Okay, naw mek wi si aw dis mɛrɛsin de wok insay di bɔdi?
Fɔ ɔndastand dis, lɛ wi yuz wan simpul ɛgzampul. Imajin se di say we yu bɔdi de go ɔlsay na yu bɔdi tan lɛk paip dɛn we de kɛr wata go na gadin. Yu at na di motoka we de pɔmp di wata tru am.
1. Wetin Valsartan de du: We at nɔ de wok fayn, dɛn blɔd vesel ya (arteries) kin kɔnstrikt ɛn blok. Dɔn di at gɛt fɔ wok tranga wan ɛn pɔmp blɔd (atɛri) wit big prɛshɔn. Valsartan de wok bay we i de dilayt ɛn lus di blɔd vesel dɛn we dɔn kɔnstrikt . Dɔn di at kin pɔmp blɔd ɔlsay na di bɔdi izi wan we i nɔ nid fɔ wok tranga wan. Dis kin kɔntrol yu blɔd prɛshɔn bak.
2. Wetin Sacubitril de du: Dis wan difrɛn smɔl. wi bכdi de prodyuz "gud hכmon" dεm we de εp di at, dilet di bכdi vεsul dεm, εn εp di bכdi fכ pul di sכlt εn wata we pasmak. כltu, wan εnzym we dεn kכl "Neprilysin" (lεk bad man) de brok dכn kwik kwik wan εn pwεl dεn gud כmon dεm ya. Wetin Sacubitril de du na fɔ stɔp di bad pɔsin, di neprilysin ɛnzaym, fɔ wok . Dɔn dɛn gud ɔmon dɛn de kin de na di bɔdi fɔ lɔng tɛm ɛn du dɛn gud wok (fɔ mek blɔd prɛshɔn go dɔŋ, pul sɔl ɛn wata).
Fɔ tɔk am simpul wan, dɛn tu mɛrɛsin ya de wok togɛda fɔ ridyus di lod we de pan di at, pan ɔl we dɛn de protɛkt di natura ɔmon dɛn we de ɛp di at.
Udat dɛn kin rɛkɔmɛnd dis ARNI drɔg fɔ?
Bɔku tɛm, yu dɔktɔ go disayd if dis mɛrɛsin fayn fɔ yu bay sɔm tin dɛn.
- Fɔ pipul dɛm wae gɛt at pwɛl hat: Dɛn kin bigin yu fɔ tek dis mɛrɛsin if dɛn jɔs dɔn no se yu gɛt at pwɛl hat ɛn yu at in blɔd-pamp efyushɔn (wi kɔl dis Ejection Fraction ) na 40% ɔr less. (Dis valyu fכ nכmal hεlty pכsin de arawnd 55% - 65%).
- Fɔ di wan dɛn we de chenj frɔm ol mɛrɛsin: If yu dɔn ɔlrɛdi de tek at atak mɛrɛsin lɛk ACE inhibitor (e.g. Enalapril, Ramipril) ɔ ARB (e.g. Losartan, Telmisartan), yu kin ebul fɔ chenj to ARNI insted.
I rili impɔtant!
If yu de chenj frɔm ACE inhibitor (e.g. Enalapril) to ARNI, yu fɔ wet fɔ at le 36 awa afta yu dɔn stɔp di ACE inhibitor bifo yu stat di ARNI. If yu chenj bitwin di tu mɛrɛsin dɛn we yu nɔ gɛt dis tɛm, yu kin gɛt wan denja alɛji we dɛn kɔl angioedema , we kin mek yu fes ɛn trot swel. So, i rili impɔtant fɔ fala yu dɔktɔ in instrɔkshɔn dɛn di rayt we.
| Udat nɔ fɔ tek ARNI? | Tɔk bɔt |
|---|---|
| Pipul dɛn we gɛt alɛji bifo | If yu bin dɔn gɛt alɛji bifo we kin mek yu fes swel (angioedema) afta yu dɔn tek ACE inhibitor ɔ ARB mɛrɛsin. |
| Mama dɛn we gɛt bɛlɛ ɛn we de gi pikin milk | I nɔ fayn fɔ yuz dis mɛrɛsin we yu gɛt bɛlɛ ɔ we yu de gi pikin in bɛlɛ. |
| Pipul wae gɛt siriɔs liva sik | If yu gɛt siriɔs liva sik. |
| Pipul dɛn we de tek ɔda mɛrɛsin dɛn | If yu dɔn ɔlrɛdi de tek ɔda patikyula mɛrɛsin lɛk ACE inhibitors ɔ aliskiren. |
Wetin na di bɛnifit dɛn we ARNI mɛrɛsin gɛt?
Risach dɔn sho se ARNI drɔgs dɛn de gi sɔm impɔtant bɛnifit dɛn pas ol mɛrɛsin dɛn lɛk ACE inhibitors.
- I kin mek yu liv lɔng pasmak: Dɛn dɔn si se dis mɛrɛsin kin ridyus di risk fɔ day bikɔs ɔf at sik, we min se yu kin liv wɛl layf fɔ lɔng tɛm.
- Impruv kwaliti fɔ liv: Dis mɛrɛsin de ɛp yu fɔ du yu ɛvride wok izi wan bay we i de ridyus di sayn dɛm lɛk fɔ taya, taya, ɛn fɔ swel yu leg.
- Ridyus fɔ go na ɔspitul: Risach dɔn sho se i de ridyus di risk fɔ go ɔspitul ɔltɛm bikɔs ɔf di at sik we de wɔs bay lɛk 20%.
- Fɔ mek di at wok bak: Sɔm sik pipul dɛn at kin pɔmp (ejection fraction) kin bɛtɛ pasmak we dɛn tek dis mɛrɛsin fɔ sɔm tɛm.
Wan big stɔdi sho se if pɔsin we ol 55 ia yuz dis mɛrɛsin, i go ebul fɔ liv fɔ 2.1 ia mɔ ɛn dɛn nɔ go go na ɔspitul ɔ day bikɔs ɔf at sik.
Yu tink se wi fɔ no bak bɔt di bad tin dɛn we kin apin to wi?
Jɔs lɛk ɛni ɔda mɛrɛsin, sɔm smɔl smɔl bad tin dɛn kin apin. Bɔt nɔ wɔri, yu dɔktɔ go tich yu bɔt dɛn tin ya.
| Sɔm sayd ɛfɛkt dɛn we pɔsin kin gɛt | Wetin fɔ du? |
|---|---|
| Lɔw blɔd prɛshɔn (Hypotension) . | Yu kin gɛt diziz, yu ed kin layt, ɔ yu yay kin blu. Yu kin tɔk to yu dɔktɔ ɛn chenj di tɛm we yu de tek yu mɛrɛsin. |
| Efεkt dεm pan di kidni fכnshכn | We yu bigin fɔ tek di mɛrɛsin ɛn ɛvri sɔm mɔnt, yu dɔktɔ go du blɔd tɛst fɔ chɛk aw yu kidni de wok. If nid de, i go ajɔst di doz. |
| di potashכm lεvεl dεm we de na di bכdi de go כp (Hyperkalemia) . | Dɛn kin no dis bak bay we dɛn de du blɔd tɛst. Di dɔktɔ go de pe atɛnshɔn gud wan to dis bak. |
| Angioedema we de mek pɔsin nɔ ebul fɔ waka | Dis nɔ kin apin so ɔltɛm. If yu si se yu fes, yu lip, yu tɔŋ ɔ yu trot de swel, ɔ yu nɔ ebul fɔ blo, stɔp fɔ tek di mɛrɛsin wantɛm wantɛm ɛn go na di ɔspitul imejensi dipatmɛnt (ETU) we de nia yu. |
Dɛn sayd ɛfɛkt ya kin dɔn insay lɛk tu wiks so. If dɛn nɔ du dat, tɛl yu dɔktɔ. I kin ridyus di doz ɛn afta dat i kin ad am bak afta sɔm dez. Nɔ ɛva stɔp fɔ tek di mɛrɛsin ɔ chenj di doz if yu dɔktɔ nɔ advays yu.
Ustɛm a fɔ go to di dɔktɔ?
If yu gɛt dɛn sik ya we yu de tek ARNI, tɛl yu dɔktɔ.
- If yu gɛt siriɔs diziz
- If yu fil se yu ed layt ɛn yu yay de blu
- If yu fil se yu de lɔs kɔnshɛns
- If yu blɔd prɛshɔn ridin de dɔŋ 90 (systolic) .
Na nɔmal tin fɔ fil smɔl fɔ chenj to nyu mɛrɛsin we yu dɔn yus to ol wan. Bɔt, i impɔtant bak fɔ tink bɔt di bɛnifit dɛn we nyu tritmɛnt dɛn go briŋ kam na yu layf. Tɔk to yu dɔktɔ bɔt dis opin wan. Lisin to ɔltin klia wan bɔt di gud ɛn bad tin dɛn we dis mɛrɛsin gɛt, ɛn if i fayn fɔ yu. Dɔn yu kin disayd fɔ du sɔntin we yu no.
Mɛsej we dɛn kin kɛr go na os
- ARNI na wan rili saksesful, modɛn klas fɔ drɔgs we de trit at pwɛl hat.
- Dis na tu drɔgs we dɛn jɔyn togɛda. Wan de ridyus di lod we de pan di at, ɛn di ɔda wan de protɛkt di natura ɔmon dɛn we de ɛp di at.
- ARNI dɛn gɛt di potenshal fɔ inkrisayz layfspan, ridyus ɔspitul, ɛn impɔtant kwaliti layf we yu kɔmpia am wit ol drɔgs.
- If yu de chenj frɔm ACE inhibitor to ARNI, yu fɔ lɛf 36 awa gap.
- I rili impɔtant fɔ mek yu du blɔd tɛst di tɛm we yu dɔn sɛtul lɛk aw yu dɔktɔ advays yu, bikɔs sayd ɛfɛkt dɛn lɛk fɔ lɛ yu blɔd prɛshɔn go dɔŋ ɛn yu kidni kin pwɛl.
- Ɔltɛm, tɔk wit yu dɔktɔ opin wan bɔt us tritmɛnt we bɛtɛ fɔ yu.
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