Kodi inuyo kapena wina m'banja mwanu ali ndi vuto la mtima? Ngati ndi choncho, mwina nthawi zonse mumakhala ndi nkhawa ndi mankhwala omwe dokotala wanu akukupatsani. Mtima wanu ukatopa pang'ono, ndikofunikira kwambiri kudziwa nthawi zonse mankhwala omwe angathandize. Lero tikambirana za mankhwala atsopano omwe awonetsa zotsatira zabwino kwambiri pochiza vutoli. Ndi ARNI.
Mwachidule, kodi ARNI ndi chiyani?
ARNI kwenikweni ndi kuphatikiza kwa mankhwala awiri. Dzina lake lonse ndi Angiotensin Receptor/Neprilysin Inhibitor. Ngakhale dzinalo lingamveke ngati lovuta pang'ono, kwenikweni ndi losavuta. Lapangidwa kuti lichiritse odwala omwe ali ndi vuto la mtima.
Zigawo ziwiri zazikulu za mankhwalawa ndi izi:
1. ARB (Angiotensin II Receptor Blocker): Mankhwala 'Valsartan' ndi a gulu ili.
2. Neprilysin Inhibitor: Mankhwala otchedwa 'Sacubitril' ndi a gulu ili.
Mankhwala okhawo a ARNI omwe alipo padziko lonse lapansi omwe amaphatikiza awiriwa ndi Sacubitril/Valsartan . Izi zidavomerezedwa mu 2015.
Kodi mankhwalawa amagwira ntchito bwanji m'thupi?
Chabwino, tsopano tiyeni tiwone momwe mankhwala awiriwa pamodzi angathandizire mtima wanu.
Ganizirani mitsempha yamagazi m'thupi lanu ngati mapaipi omwe amanyamula madzi. Nthawi zina mapaipi amenewa amatsekeka ndi kupapatiza, zomwe zimapangitsa kuti mtima wanu usapope magazi.
- Valsartan (gulu la ARB): Mankhwalawa amagwira ntchito popumitsa ndi kukulitsa mitsempha yamagazi yopapatiza. Zili ngati kukulitsa chitoliro chotsekedwa. Kenako magazi amatha kuyenda m'thupi lonse popanda chopinga chilichonse. Izi zimachepetsa kuthamanga kwa magazi.
- Sacubitril (Neprilysin Inhibitor): Izi zimachita chinthu chofunika kwambiri. Matupi athu mwachibadwa amapanga mahomoni omwe amathandiza mitima yathu. Koma enzyme yotchedwa 'Neprilysin' imawononga mahomoni abwino awa. Sacubitril imaletsa enzyme yoipayo kugwira ntchito. Ikasiya, matupi athu amatha:
- Chotsani sodium (mchere) wosafunikira m'thupi kudzera mu mkodzo.
- Pangani mitsempha yamagazi kukhala yokulirapo.
- Kupanga mkodzo wambiri ndi kuchepetsa madzi ochulukirapo m'thupi.
Mwachidule, kuphatikiza kwa mankhwala awiriwa kumachepetsa mtolo pamtima ndipo kumapangitsa kuti ntchito yake ikhale yosavuta. Zili ngati kukhala ndi anthu ena awiri obwera kudzathandiza munthu amene akugwira ntchito molimbika.
Kodi ARNI ikulimbikitsidwa kwa ndani?
Mankhwalawa si a aliyense. Dokotala wanu adzasankha ngati mankhwalawa ndi oyenera kwa inu potengera zinthu zingapo.
| Kuyenerera | Kufotokozera |
|---|---|
| Kwa iwo omwe ali ndi vuto lochepa la kupopa kwa mtima | Ngati mwapezeka ndi matenda a mtima ndipo Ejection Fraction (EF) yanu, yomwe ndi njira yodziwira momwe mtima umagwirira ntchito, ndi 40% kapena kuchepera (mwa munthu wathanzi, izi ndi pafupifupi 55%-65%). |
| Kwa iwo omwe asintha kuchoka ku mankhwala ena | Ngati mukumwa kale mankhwala oletsa ACE kapena ARB chifukwa cha kulephera kwa mtima, mutha kusintha kupita ku ARNI m'malo mwake. |
Chofunika Kwambiri: Ngati mukusintha kuchoka pa mankhwala oletsa ACE (monga Enalapril, Lisinopril) kupita ku ARNI, dikirani maola 36 mutasiya kugwiritsa ntchito ACE inhibitor musanayambe ARNI. Kulephera kutero kungayambitse vuto la ziwengo (angioedema), lomwe ndi kutupa pansi pa khungu. Dokotala wanu adzakulangizani pa izi.
Ubwino wa ARNI ndi zifukwa zogwiritsira ntchito
Anthu ambiri amasintha kugwiritsa ntchito ma ARNI chifukwa cha zotsatirapo zake, monga chifuwa chosatha, chomwe chimabwera ndi mankhwala akale monga ACE inhibitors. Koma si chifukwa chokhacho. Pali ubwino wambiri wogwiritsa ntchito ma ARNI.
- Amawonjezera moyo: Kafukufuku wapeza kuti mankhwalawa amachepetsa chiopsezo cha imfa zokhudzana ndi matenda a mtima.
- Zimathandiza kuti moyo ukhale wabwino: Zimachepetsa zizindikiro monga kutopa ndi kutopa, zomwe zimakuthandizani kuti muzigwira ntchito bwino.
- Amalamulira kupita patsogolo kwa matenda: Amachepetsa liwiro lomwe mtima umalephera kugwira ntchito bwino.
- Amachepetsa kugonekedwa m'chipatala: Zatsimikiziridwa kuti anthu omwe amamwa mankhwalawa sapezeka m'chipatala chifukwa cha kulephera kwa mtima.
- Zimathandiza kuti mtima ugwire bwino ntchito: Kafukufuku wina anasonyeza kuti atamwa ARNI kwa chaka chimodzi, kuchuluka kwa magazi omwe wodwala amatuluka m'thupi kunawonjezeka kuchoka pa 28% kufika pa 38%. Izi zikutanthauza kuti mphamvu ya mtima yopopa magazi inakula kwambiri.
Malinga ndi kafukufuku wamkulu, anthu omwe amatenga ARNI ali ndi chiopsezo chotsika cha 20% cha imfa kapena kugonekedwa m'chipatala chifukwa cha matenda a mtima.
Ndani sayenera kugwiritsa ntchito mankhwalawa?
Mankhwalawa si oyenera anthu ena. Ngati muli m'gulu lililonse mwa magulu amenewa, madokotala amanena kuti simuyenera kumwa mankhwalawa.
| Udindo | Chifukwa |
|---|---|
| Amayi oyembekezera kapena oyamwitsa | Chifukwa zingavulaze mwana. |
| Anthu omwe kale anali ndi angioedema | Ngati mudayamba kale kudwala angioedema, kutupa kwa nkhope kapena milomo, chifukwa cha mankhwala oletsa ACE kapena ARB. |
| Amene akutenga kale ACE inhibitor/ARB | Ndikoopsa kumwa mankhwala onse awiri pamodzi. |
| Anthu omwe ali ndi matenda aakulu a chiwindi | Mankhwalawa si oyenera ngati chiwindi chanu sichikugwira ntchito bwino. |
| Anthu omwe akutenga Aliskiren | Sikoyenera kumwa ARNI ngati mukumwa Aliskiren ndi matenda a shuga kapena impso. |
Tiyeni tiphunzirenso za zotsatirapo zake.
Monga mankhwala ena aliwonse, ARNI ingayambitse zotsatirapo zazing'ono. Komabe, si aliyense amene amalandira.
- Kuthamanga kwa magazi pang'ono (Hypotension): Mungamve chizungulire komanso mutu wopepuka.
- Zotsatira pa ntchito ya impso: Anthu ena angakumane ndi kuchepa pang'ono kwa ntchito ya impso.
- Kuchuluka kwa potaziyamu m'magazi (Hyperkalemia): Izi zitha kuchitikanso mwa anthu ena.
- Angioedema: Kutupa kwa nkhope, milomo, ndi lilime. Izi sizichitika kawirikawiri , koma zingakhale zoopsa kwambiri ngati zitachitika.
Ichi ndichifukwa chake dokotala wanu adzayesa magazi anu (kuti aone impso zanu ndi kuchuluka kwa potaziyamu) ndi kuthamanga kwa magazi kwa milungu ingapo yoyambirira mukayamba kumwa mankhwalawa. Ngati pali vuto lililonse, dokotala wanu adzachepetsa mlingo kapena kukuuzani choti muchite. Musasiye kumwa mankhwalawa popanda upangiri wa dokotala wanu.
Zotsatirapozi nthawi zambiri zimatha mkati mwa milungu iwiri. Ngati zikupitirira, dziwitsani dokotala wanu nthawi yomweyo.
Kodi ndiyenera kupita kwa dokotala liti?
Ngati mukukumana ndi zizindikiro izi mukatenga ARNI, onetsetsani kuti mwalankhula ndi dokotala wanu.
- Chizungulire pafupipafupi
- Kusadzikuza
- Nthawi zina kukomoka
- Kuthamanga kwa magazi kotsika kwambiri (ngati chiwerengero cha systolic chili pansi pa 90)
Mungakhale ndi mantha pang'ono kusintha mankhwala atsopano mukazolowera mankhwala akale. Koma kuphunzira za mankhwala atsopano komanso ogwira mtima komanso kulankhula ndi dokotala wanu za zabwino ndi zoyipa zake ndikofunikira kwambiri pa thanzi lanu.
Uthenga Wopita Nawo Kunyumba
- ARNI ndi mankhwala amakono opambana komanso opangidwa ndi kuphatikiza kwa mankhwala awiri ochizira kulephera kwa mtima.
- Izi zimakulitsa mitsempha yamagazi, zimachotsa mchere ndi madzi osafunikira m'thupi, komanso zimachepetsa mtolo pamtima.
- Mankhwalawa amapereka zabwino zambiri, kuphatikizapo moyo wautali, kukhala ndi moyo wabwino, komanso kuchepetsa kugona m'chipatala.
- Mankhwalawa si oyenera amayi apakati, omwe kale anali ndi angioedema, komanso omwe ali ndi matenda ena.
- Zotsatirapo zina monga chizungulire ndi kutsika kwa kuthamanga kwa magazi zimatha kuchitika. Chifukwa chake, ndikofunikira kukhala pansi pa kuyang'aniridwa ndi dokotala nthawi zonse.
- Musayambe kapena kusiya kumwa mankhwalawa popanda upangiri wa dokotala. Ngati muli ndi vuto lililonse, funsani dokotala wanu nthawi yomweyo.
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