Doctor-in i thinlung a chak loh thu a hrilh che emaw, kan tih ang hian thinlung natna (heart failure condition) i nei tih emaw a hrilh che chuan hlauhna leh lungkhamna nasa tak i neih hi thil pangngai a ni. Chauhna, ke hring, leh zan mut mut theih loh ang chi harsatna te nena khawsak a harsat zia chu i hria a, thawhrimna tlemte hnuah pawh. He natna atana damdawi hlui pek thenkhat nena lo awm, khuh ang chi side effects te hi a lungchhiatthlak zawk theih hun a awm bawk. Mahse, medical science hmasawnna avang hian tunah chuan hetiang dinhmun atan hian enkawlna hlawhtling tak tak leh thar tak tak a lo chhuak ta a ni. Chutiang ruihhlo chi thar pakhat, mi tam tak tan hahdamna thlentu chu ARNI hi a ni. Hemi chungchang hi vawiinah hian i sawi mai ang u.
A awlsam zawngin ARNI chu eng nge ni?
ARNI tih hming hi a buaithlak deuhin a lang thei a, mahse a awmzia erawh a awlsam khawp mai. ARNI (Angiotensin Receptor/Neprilysin Inhibitor) hi damdawi bik a ni a, damdawi chi hnih inzawmkhawma lung natna enkawlna atana siam a ni . Team khata infiammi thiam pahnih inkhelh dun ang bawkin, heng damdawi pahnih hian i thinlungah hahdamna nasa tak pe turin an thawk dun a ni.
Heng damdawi pahnih hi:
1. ARB (Angiotensin II Receptor Blocker): Hei hi a hming chu Valsartan a ni.
2. Neprilysin Inhibitor: Hei hi a hming chu Sacubitril a ni.
Tunah hian Sri Lanka leh khawvela ARNI damdawi hman awmchhun chu Sacubitril/Valsartan a ni. Hei hi kum 2015 khan pawm a ni.
Awle, tunah chuan he damdawi hian taksa chhungah engtin nge hna a thawh tih i en ang u?
Hei hi hrethiam tur chuan entirnan awlsam tak hmang ila. I taksaa thisen kalna (circulatory system) chu huana tui phurtu pipe system ang mai niin han ngaihtuah teh. I thinlung hi a chhunga tui pump chhuaktu motor a ni.
1. Valsartan-in a tih: Heart failure-ah hian heng thisen kalna kawng (arteries) te hi a inkharkhip a, a inkharkhip thin. Tichuan thinlung hian nasa takin hna a thawk a ngai a, thisen (arteries) chu pressure nasa tak nen a pump a ngai a ni. Valsartan hian thisen kalna kawngkhar (constricted blood vessels) te chu a tizau a , a tizau bawk . Tichuan thinlung hian hetiang taka hna thawh ngai lovin taksa pum puiah awlsam zawkin thisen a pump thei a ni. Hei hian i thisen sang a control bawk.
2. Sacubitril thil tih: Hemi hi a danglam deuh. Kan taksa hian a pianphungah "hormone tha" a siam chhuak a, chu chuan thinlung a pui a, thisen kalna a tizau a, taksain chi leh tui tam lutuk a paih chhuak thei bawk. Mahse, enzyme pakhat "Neprilysin" (mi sual ang maiin) chuan rang takin a chhe vek a, heng hormone tha tak takte hi a tichhia a ni. Sacubitril hian a tih chu misual, neprilysin enzyme hnathawh tur a titawp a ni . Tichuan chu hormone tha te chu taksaah rei zawk an awm thei a, an hna tha (thisen sang tihhniam, chi leh tui paih) an thawk thei bawk.
A awlsam zawngin sawi ila, heng damdawi pahnih hian thinlunga phurrit tihziaawmna turin an thawk dun a, chutih rualin thinlung puitu natural hormone te chu an venghim bawk.
He ARNI damdawi hi tute tan nge recommended?
I doctor chuan he damdawi hi i tan a tha em tih chu thil engemaw zat atanga thlirin a rel tlangpui ang.
- Lung chak lohna nei tan: He damdawi hi i ei tan mai thei a, chu chu heart failure i nei tih hmuhchhuah thar i nih a, i thinlung thisen pump efficiency (hei hi Ejection Fraction kan ti thin ) 40% emaw a aia tlem emaw a nih chuan. (Mi hrisel pangngai tan chuan he value hi 55% - 65% vel a ni).
- Damdawi hlui atanga inthlak thinte tan: Heart attack damdawi ACE inhibitor (e.g. Enalapril, Ramipril) emaw ARB (e.g. Losartan, Telmisartan) emaw i ei tawh a nih chuan, chu ai chuan ARNI-ah i inthlak thei mai thei.
A pawimawh hle mai!
ACE inhibitor (e.g. Enalapril) atanga ARNI i thlak dawn a nih chuan ACE inhibitor i tihtawp hnu darkar 36 tal ARNI i tan hmain i nghah tur a ni. Hetiang hun chhung awm lovin damdawi pahnih hi i thlak danglam chuan allergic reaction hlauhawm tak angioedema , i nei thei a, chu chuan hmai leh kawr a ti na a ni. Chuvang chuan doctor thupek dik taka zawm a pawimawh hle.
| Tuin nge ARNI ei loh tur? | Hrilhfiahna |
|---|---|
| Tun hmaa allergy nei tawhte | Tun hmaa ACE inhibitor emaw ARB damdawi emaw ei hnua hmai hring (angioedema) thlentu allergic reaction i neih tawh chuan. |
| Nu naupai leh nau hnute pe mek | He damdawi hi naupai lai emaw, nau hnute pek lai emawa hman a tha lo. |
| Thin natna khirh tak nei te | Liver natna na tak i neih chuan. |
| Mite damdawi dang ei thin | Damdawi bik dang ACE inhibitor emaw aliskiren emaw i ei tawh a nih chuan. |
ARNI damdawi hian eng hlawkna nge a neih?
Research atanga a lan dan chuan ARNI damdawi hian damdawi hlui ACE inhibitor te aiin hlawkna lian tham engemaw zat a nei a ni.
- Dam rei zawk: He damdawi hian lung natna avanga thihna a tihziaawm tih hmuhchhuah a ni a, chu chu dam rei zawkin nun hrisel zawkin i nung thei tihna a ni.
- Nunphung tihchangtlun: He damdawi hian nitin hnathawh awlsam zawk nan a pui che a, hahna, hahna, leh ke hring ang chi natna lanchhuahna te a tihziaawm thei a ni.
- Damdawi ina awm tam lohna: Zirchianna atanga a lan dan chuan thinlung natna zual zel avanga damdawi ina awm fo theihna chu 20% velin a tihniam a ni.
- Lung hnathawh that leh: Damlo thenkhat chuan he damdawi hi hun engemaw chen an ei hian an thinlung pump theihna (ejection fraction) chu nasa takin a tha chho thin.
Zirchianna lian tak pakhatah chuan kum 55 mi chuan he damdawi hi a hmang a nih chuan damdawi inah awm lovin, thinlung natna avanga thi lovin kum 2.1 dang a dam thei dawn tih a tarlang.
Side effects pawh kan hre tur em ni?
Damdawi dang ang bawkin, side effect tenau tak tak a awm thei bawk. Mahse, lungngai suh, i doctor-in hengte hi a zirtir ang che.
| Side effect awm thei te | Engtin nge tih ang? |
|---|---|
| Thisen sang hniam (Hypotension) . | I luak chhuak thei a, lu a hring thei a, mitmeng i nei thei bawk. I doctor nen in inbia a, i damdawi ei hun chhung pawh i thlak thei bawk. |
| Kidney hnathawh danah nghawng a nei | Damdawi i ei tan hunah leh thla engemaw zat hnuah i doctor chuan i kal hnathawh dan enfiah turin thisen test a nei ang. A tul chuan a dose a siamrem ang. |
| Thisen a potassium level sang (Hyperkalemia) . | Hei hi thisen test hmanga hriat theih a ni bawk. Hei pawh hi doctor chuan a ngaihven hle dawn a ni. |
| Angioedema a awm thin | Hei hi a tlem hle. Hmai, hmui, lei emaw, kawr emaw a hring a, thawk harsa i tih chuan damdawi ei kha bansan nghal la, damdawi in hnai ber emergency department (ETU)-ah kal rawh. |
Heng side effects te hi kar hnih vel chhungin a bo tlangpui. An tih loh chuan i doctor hnenah hrilh rawh. A dose chu a tihhniam thei a, ni engemaw zat hnuah a tipung leh thei bawk. Doctor thurawn tel lo chuan damdawi ei kha bansan ngai suh la, a dose pawh thlak ngai suh.
Engtikah nge Doctor ka hmuh ang?
ARNI i ei laiin a hnuaia symptoms te hi i neih chuan doctor hnenah hriattir tur a ni.
- Luak chhuak nasa tak i neih chuan
- Lu a hring tih i hriat a, i mit a sen vek chuan
- I hriatna hloh ang maia i hriat chuan
- I thisen sang chhiar dan 90 hnuai lam a nih chuan (systolic) .
Damdawi hlui i hman tawh chuan damdawi thar lama inthlak chungchangah hian hlauhna tlem i neih hi thil pangngai a ni. Mahse, enkawlna thar hian i nunah hlawkna a thlen theih dan tur ngaihtuah a pawimawh bawk. Hemi chungchang hi i doctor nen inhawng takin sawi rawh. He damdawi thatna leh that lohna zawng zawng chiang takin ngaithla la, i tan a tha em tih pawh ngaithla rawh. Tichuan, thu tlûkna dik tak i siam thei ang.
Take-Home Thuchah a ni
- ARNI hi heart failure enkawlna atana hmanraw hlawhtling tak, tunlai class a ni.
- Hei hi damdawi pahnih inkawp a ni. Pakhat chuan thinlunga phurrit a tihziaawm a, pakhat zawk chuan thinlung puitu natural hormone a venghim bawk.
- ARNIs hian damdawi hlui nena khaikhin chuan dam rei theihna a nei a, damdawi ina awm zat a tihtlem thei a, nunphung a tichangtlung thei bawk.
- ACE inhibitor atanga ARNI lama i inthlak dawn a nih chuan darkar 36 chhunga inthlauhna i dah a ngai a ni.
- Doctor thurawn angin a hun ruatah thisen test neih a pawimawh hle a, side effects, thisen sang hniam leh kal chhiatna te a awm thei a ni.
- I doctor nen hian eng damdawi nge i tana tha ber tih chungchangah inbiakna zau tak nei fo ang che.
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