Zvakajairika kunzwa kutya uye kunetseka zvikuru kana chiremba akakuudza kuti moyo wako hauna simba, kana sezvatinoti, une chirwere chemwoyo. Unoziva kuti zvakaoma sei kurarama nematambudziko akadai sekuneta, kuzvimba makumbo, uye kusakwanisa kurara zvakanaka husiku kunyangwe mushure mekuedza zvishoma. Pane dzimwe nguva apo migumisiro senge kukosora kunouya nemimwe yemishonga yekare yakapihwa yechirwere ichi inogona kuodza mwoyo zvakanyanya. Zvisinei, nekufambira mberi kwesainzi yezvekurapa, mishonga mitsva yave kuzivikanwa yezvirwere zvakadaro. Imwe mhando yemishonga mitsva yakaunza zororo kuvanhu vazhinji iARNI. Ngatitaurei nezvazvo nhasi.
Zvichitaurwa zviri nyore, chii chinonzi ARNI?
Kunyange zvazvo zita rekuti ARNI ringanzwika serakaoma, zvarinoreva zviri nyore. ARNI (Angiotensin Receptor/Neprilysin Inhibitor) mushonga unokosha unogadzirwa nekubatanidza mhando mbiri dzemishonga kurapa zvirwere zvemwoyo. Kufanana nevatambi vaviri vane tarenda vanotamba pamwe chete muchikwata chimwe chete, mishonga iyi miviri inoshanda pamwe chete kuti ipe zororo guru kumoyo wako.
Mishonga iyi miviri ndeiyi:
1. ARB (Angiotensin II Receptor Blocker): Zita reizvi ndiValsartan.
2. Neprilysin Inhibitor: Zita reizvi ndiSacubitril.
Parizvino, mushonga weARNI chete uri kushandiswa muSri Lanka nepasi rose ndiSacubitril/Valsartan . Uyu wakatenderwa muna 2015.
Zvakanaka, ngationei kuti mushonga uyu unoshanda sei mumuviri?
Kuti tinzwisise izvi, ngatishandisei muenzaniso uri nyore. Fungidzira kuti nzira yeropa iri mumuviri wako yakafanana nehurongwa hwemapaipi anotakura mvura kuenda kubindu. Mwoyo wako ndiwo mota inopomba mvura nepakati pawo.
1. Zvinoitwa naValsartan: Mukurwadziwa kwemoyo, mitsipa iyi yeropa (tsinga) inovharika uye inovharika. Ipapo moyo unofanirwa kushanda nesimba uye unopomba ropa (tsinga) nekumanikidzwa kukuru. Valsartan inoshanda nekutambanudza nekusunungura mitsipa yeropa yakavharika . Ipapo moyo unogona kupomba ropa mumuviri wese zviri nyore pasina kushanda nesimba. Izvi zvinodzorawo BP yako.
2. Zvinoitwa neSacubitril: Uyu wakasiyana zvishoma. Miviri yedu inobereka "mahormone akanaka" anobatsira mwoyo, anotambanudza mitsipa yeropa, uye anobatsira muviri kubvisa munyu nemvura yakawandisa. Zvisinei, enzyme inonzi "Neprilysin" (semunhu akaipa) inokurumidza kupwanyika uye inoparadza mahormone aya akanaka. Zvinoitwa neSacubitril ndezvekuti inomisa munhu akaipa, enzyme yeneprilysin, kuti isashande . Ipapo mahormone akanaka iwayo anogona kugara mumuviri kwenguva yakareba uye oita basa rawo rakanaka (kuderedza BP, kubvisa munyu nemvura).
Zvichitaurwa zviri nyore, mishonga iyi miviri inoshanda pamwe chete kuderedza mutoro pamoyo, ukuwo ichidzivirira mahormone echisikigo anobatsira moyo.
Mushonga uyu weARNI unokurudzirwa ani?
Chiremba wako anowanzo sarudza kana mushonga uyu wakakunakira zvichibva pane zvimwe zvinhu.
- Kune vanhu vane chirwere chemwoyo: Unogona kutanga kushandisa mushonga uyu kana wakaonekwa uine chirwere chemwoyo uye kushanda kwemoyo wako pakupomba ropa (tinoti Ejection Fraction ) kuri 40% kana pasi. (Kukosha uku kumunhu ane hutano hwakanaka kuri pakati pe55% - 65%).
- Kune avo vanochinja kubva pamishonga yekare: Kana muchitotora mishonga yekurwisa chirwere chemwoyo yakaita seACE inhibitor (semuenzaniso Enalapril, Ramipril) kana ARB (semuenzaniso Losartan, Telmisartan), munogona kuchinja kuenda kuARNI.
Zvakakosha zvikuru!
Kana uri kuchinja kubva pakushandisa ACE inhibitor (semuenzaniso Enalapril) kuenda kuARNI, unofanira kumirira kwemaawa makumi matatu nematanhatu mushure mekumira kushandisa ACE inhibitor usati watanga ARNI. Kana ukachinja pakati pemishonga miviri iyi pasina nguva iyi, unogona kutanga chirwere cheallergy chinonzi angioedema , chinokonzera kuzvimba kwechiso nepahuro. Saka, zvakakosha kuti uteedzere mirairo yachiremba wako nemazvo.
| Ndiani asingafaniri kutora ARNI? | Tsananguro |
|---|---|
| Vanhu vakambova neallergies | Kana wakambova neallergy inokonzera kuzvimba kwechiso (angioedema) mushure mekutora mushonga weACE inhibitor kana ARB. |
| Madzimai ane pamuviri uye anoyamwisa | Mushonga uyu haukurudzirwi kushandiswa panguva yekuzvitakura kana panguva yekuyamwisa. |
| Vanhu vane chirwere chakakomba chechiropa | Kana uine chirwere chechiropa chakakomba. |
| Vanhu vari kutora mimwe mishonga | Kana watove kutora mimwe mishonga chaiyo yakadai seACE inhibitors kana aliskiren. |
Ndezvipi zvakanakira mushonga weARNI?
Ongororo yakawana kuti mishonga yeARNI ine mabhenefiti akawanda akakosha kupfuura mishonga yekare yakadai seACE inhibitors.
- Kuwedzera kwetariro yekurarama: Mushonga uyu wakawanikwa uchideredza njodzi yekufa nechirwere chemwoyo, zvichireva kuti unogona kurarama hupenyu hune hutano kwenguva yakareba.
- Hunhu hwehupenyu huri nani: Mushonga uyu unokubatsira kuita mabasa ako ezuva nezuva zviri nyore nekuderedza zviratidzo zvakaita sekuneta, kuneta, uye kuzvimba kwemakumbo.
- Kudzikira kwekuramba vachienda kuchipatara: Ongororo yakaratidza kuti inoderedza njodzi yekuramba vachienda kuchipatara nekuda kwechirwere chemwoyo chinowedzera ne20%.
- Kudzoreredza mashandiro emoyo: Kugona kwevamwe varwere kupomba mwoyo (chikamu chekuburitsa ropa) kunovandudzika zvakanyanya pavanotora mushonga uyu kwenguva yakati.
Imwe ongororo yakakura yakawana kuti kana munhu ane makore makumi mashanu nemashanu ekuberekwa akashandisa mushonga uyu, achakwanisa kurarama mamwe makore maviri nerimwe asina kuendeswa kuchipatara kana kufa nechirwere chemwoyo.
Tinofanirawo kuziva nezvemigumisiro yemishonga iyi here?
Sezvinongoita chero mishonga, panogona kunge paine zvimwe zvinhu zvidiki zvinokanganisa. Asi musazvidya mwoyo, chiremba wenyu achakudzidzisai nezvazvo.
| Migumisiro inogona kuitika | Chii chekuita? |
|---|---|
| Kuderera kweropa (Hypotension) | Unogona kunzwa dzungu, kusviba musoro, kana maziso ebhuruu. Unogona kutaura nachiremba wako wochinja nguva yaunotora mushonga wako. |
| Mhedzisiro pakushanda kweitsvo | Kana watanga kutora mushonga uye mwedzi mishoma yega yega, chiremba wako achaita bvunzo yeropa kuti aongorore mashandiro eitsvo dzako. Kana zvichidikanwa, iye achagadzirisa mwero wemushonga. |
| Kuwedzera kwepotassium muropa (Hyperkalemia) | Izvi zvinogonawo kuonekwa kuburikidza nekuongororwa ropa. Chiremba achanyatsoteerera izvi zvakare. |
| Kuora kweAngioedema | Izvi hazviwanzoitiki. Kana ukaona kuzvimba kwechiso, miromo, rurimi kana pahuro, kana kufema zvakaoma, rega kutora mushonga nekukasika woenda kuchipatara chiri pedyo (ETU). |
Migumisiro iyi inowanzopera mukati memavhiki maviri. Kana ikasadaro, udza chiremba wako. Anogona kuderedza mushonga wozowedzera zvakare mushure memazuva mashoma. Usamborega kutora mushonga kana kuchinja mushonga usina kurairwa nachiremba wako.
Ndinofanira kuona chiremba rini?
Kana ukaona zviratidzo zvinotevera paunenge uchitora ARNI, zivisa chiremba wako.
- Kana uchinzwa dzungu rakakomba
- Kana uchinzwa musoro wakachena uye maziso ako ava kuita bhuruu
- Kana uchinzwa sekunge uri kurasikirwa nepfungwa
- Kana BP yako iri pasi pe90 (systolic)
Zvakajairika kuti unzwe kutya zvishoma nezvekuchinja mushonga mutsva kana wajaira wekare. Zvisinei, zvakakoshawo kufunga nezvemabhenefiti achaunzwa nemishonga mitsva muhupenyu hwako. Taura nachiremba wako nezveizvi pachena. Teerera zvese zvakajeka nezvezvakanaka nezvakaipa zvemushonga uyu, uye kana wakakunakira. Ipapo unogona kuita sarudzo yakavakirwa paruzivo.
Mharidzo Yekuenda Nayo Kumba
- ARNI imhando yemishonga yemazuva ano inobudirira zvikuru inorapa kutadza kushanda kwemoyo.
- Uyu musanganiswa wemishonga miviri. Mumwe unoderedza mutoro pamoyo, uye mumwe unodzivirira mahormone echisikigo anobatsira moyo.
- Mishonga yeARNI ine mukana wekuwedzera hupenyu hwemurwere, kuderedza kugara muchipatara, uye kuvandudza hupenyu hwake zvichienzaniswa nemishonga yekare.
- Kana uchichinja kubva paACE inhibitor kuenda kuARNI, unofanira kusiya mukaha wemaawa makumi matatu nematanhatu.
- Zvakakosha kuti uongororwe ropa panguva dzakatarwa sezvakarairwa nachiremba wako, sezvo migumisiro yakadai sekushomeka kweropa uye kukuvara kweitsvo inogona kuitika.
- Gara uchikurukura pachena nachiremba wako nezvekurapa kwakakunakira.
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