Iwe kana mumwe munhu mumhuri mako ane chirwere chemwoyo here? Kana zvakadaro, pamwe unogara uchinetseka nezvemishonga yaunonyorerwa nachiremba. Kana moyo wako waneta zvishoma, zvakakosha kugara uchiziva mishonga inogona kuubatsira. Nhasi tichataura nezvemushonga mutsva wakabudirira zvikuru mukurapa chirwere ichi. Ndiyo ARNI.
Zvichitaurwa zviri nyore, chii chinonzi ARNI?
ARNI musanganiswa wemishonga miviri. Zita rayo rakazara ndiAngiotensin Receptor/Neprilysin Inhibitor. Kunyange zvazvo zita racho ringanzwika serakaoma, asi riri nyore. Rakagadzirirwa kurapa varwere vane chirwere chemwoyo.
Zvikamu zviviri zvikuru zvemushonga uyu ndeizvi:
1. ARB (Angiotensin II Receptor Blocker): Mushonga we'Valsartan' ndeweboka iri.
2. Neprilysin Inhibitor: Mushonga wekuti 'Sacubitril' ndeweboka iri.
Mushonga weARNI chete uripo pasi rose unosanganisa izvi zviviri iSacubitril /Valsartan . Uyu wakatenderwa muna 2015.
Mushonga uyu unoshanda sei mumuviri?
Zvakanaka, ngationei kuti mishonga iyi miviri pamwe chete ingabatsira sei moyo wako.
Funga nezvetsinga dzeropa dziri mumuviri wako semapaipi anotakura mvura. Dzimwe nguva mapaipi aya anovharika uye anotetepa, zvichiita kuti zviomere mwoyo wako kupomba ropa.
- Valsartan (kirasi yeARB): Mushonga uyu unoshanda nekuzorodza nekukudza tsinga dzeropa dzakatetepa. Zvakafanana nekukudza pombi yakavharika. Ipapo ropa rinogona kuyerera mumuviri wese pasina chipingamupinyi. Izvi zvinoderedza BP.
- Sacubitril (Neprilysin Inhibitor): Izvi zvinoita chimwe chinhu chakakosha zvikuru. Miviri yedu inobereka mahormone anobatsira mwoyo yedu. Asi enzyme inonzi 'Neprilysin' inoparadza mahormone aya akanaka. Sacubitril inomisa enzyme iyoyo yakaipa kushanda. Kana yamira, miviri yedu inogona:
- Bvisa sodium (munyu) isingadiwe mumuviri kuburikidza neweti.
- Ita kuti tsinga dzeropa dziwedzere.
- Kuburitsa weti yakawanda uye kuderedza mvura yakawandisa mumuviri.
Zvichitaurwa zviri nyore, kusanganiswa kwemishonga iyi miviri kunoderedza mutoro pamoyo uye kunoita kuti kushanda kwayo kuve nyore. Zvakafanana nekuva nevamwe vanhu vaviri vauya kuzobatsira munhu ari kushanda nesimba.
ARNI inokurudzirwa kunaani?
Mushonga uyu hausi wemunhu wese. Chiremba wako ndiye achasarudza kana mushonga uyu wakakunakira zvichibva pane zvimwe zvinhu.
| Kukodzera | Tsananguro |
|---|---|
| Kune avo vane kushaya simba kwemoyo | Kana wakamboonekwa uine Heart Failure uye Ejection Fraction (EF) yako, iyo inoyera kushanda kwemoyo, iri 40% kana pasi (mumunhu ane hutano, kukosha uku kuri pakati pe55%-65%). |
| Kune avo vanochinja kubva kune mimwe mishonga | Kana watove kutora mishonga yeACE inhibitors kana ARBs yekushaya simba kwemoyo, unogona kushandisa ARNIs pachinzvimbo. |
Zvakakosha: Kana uri kuchinja kubva pakushandisa ACE inhibitor (semuenzaniso Enalapril, Lisinopril) kuenda kuARNI, mirira maawa makumi matatu nematanhatu mushure mekumira kushandisa ACE inhibitor usati watanga ARNI. Kukundikana kuita izvi kunogona kukonzera allergic reaction ine njodzi (angioedema), iyo iri kuzvimba pasi peganda. Chiremba wako achakupa mazano pane izvi.
Mabhenefiti eARNI uye zvikonzero zvekuishandisa
Vanhu vazhinji vanochinja kushandisa maARNI nekuda kwemigumisiro yakaipa, yakadai sekukosora kusingaperi, kunouya nemishonga yekare senge ACE inhibitors. Asi handizvo chete chikonzero. Kune mabhenefiti akawanda ekushandisa maARNI.
- Inowedzera hupenyu hwemunhu: Ongororo dzakawana kuti mushonga uyu unoderedza njodzi yekufa nekuda kwechirwere chemwoyo.
- Inovandudza hupenyu: Inoderedza zviratidzo zvakaita sekuneta nekuneta, zvichikubatsira kuti ushande zvakanaka.
- Inodzora kufambira mberi kwechirwere: Inoderedza mwero wekuti kutadza kwemoyo kunowedzera sei.
- Inoderedza kugara muchipatara: Zvave zvichiratidzwa kuti vanhu vanotora mushonga uyu vane nguva shoma yekuenda kuchipatara nekuda kwekushaya simba kwemoyo.
- Inovandudza mashandiro emoyo: Imwe ongororo yakaratidza kuti mushure mekutora ARNI kwegore rose, chikamu chekubuda kweropa chevarwere chakawedzera kubva paavhareji ye28% kusvika pa38%. Izvi zvinoreva kuti kugona kwemoyo kupomba kwakavandudzika zvakanyanya.
Zvichienderana neongororo yakakura, vanhu vanotora ARNI vane mukana wakaderedzwa we20% wekufa kana kugara muchipatara nekuda kwechirwere chemwoyo.
Ndiani asingafaniri kushandisa mushonga uyu?
Mushonga uyu haukodzeri vamwe vanhu. Kana uri weboka revamwe, vanachiremba vanoti haufanirwe kutora mushonga uyu.
| Chinzvimbo | Chikonzero |
|---|---|
| Amai vane pamuviri kana kuti vanoyamwisa | Nekuti zvinogona kukuvadza mwana. |
| Vanhu vakambova ne angioedema | Kana wakambova ne angioedema, kuzvimba kwechiso kana miromo, nekuda kwekushandisa mushonga weACE inhibitor kana ARB. |
| Avo vatove kutora mushonga weACE inhibitor/ARB | Zvine njodzi kutora mishonga yese iri miviri pamwe chete. |
| Vanhu vane chirwere chakakomba chechiropa | Mushonga uyu haukodzeri kana chiropa chako chisina kushanda zvakanaka. |
| Vanhu vari kutora Aliskiren | Hazvikurudzirwi kutora ARNI kana uri kutora Aliskiren une chirwere cheshuga kana chirwere cheitsvo. |
Ngatidzidzeiwo nezvemigumisiro yakaipa.
Kufanana nemushonga upi zvawo, ARNI inogona kukonzera migumisiro midiki. Zvisinei, havasi vese vanoiwana.
- Kuderera kweropa (Hypotension): Unganzwa dzungu uye musoro wakareruka.
- Mhedzisiro pakushanda kweitsvo: Vamwe vanhu vanogona kuona kudzikira kwekushanda kweitsvo.
- Kuwedzera kwehuwandu hwepotassium muropa (Hyperkalemia): Izvi zvinogonawo kuitika kune vamwe vanhu.
- Angioedema: Kuzvimba kwechiso, miromo, nerurimi. Izvi hazviwanzoitiki , asi zvinogona kuva nengozi zvikuru kana zvikaitika.
Ndosaka chiremba wako achizoongorora ropa rako (kuti aongorore huwandu hweitsvo dzako nepotassium) uye BP kwemavhiki mashoma ekutanga paunotanga kutora mushonga uyu. Kana paine matambudziko, chiremba wako achaderedza dose kana kukuudza zvekuita. Usamborega kutora mushonga uyu usina kurayirwa nachiremba wako.
Migumisiro iyi inowanzopera mukati memavhiki maviri. Kana ikaramba iripo, zivisa chiremba wako nekukasika.
Ndinofanira kuona chiremba rini?
Kana ukaona chimwe chezviratidzo izvi paunenge uchitora ARNI, iva nechokwadi chekutaura nachiremba wako.
- Dzungu rinowanzoitika
- Kusava nemusoro
- Dzimwe nguva kufenda
- Kuderera kweropa zvakanyanya (kana chiyero che systolic chiri pasi pe90)
Ungatya zvishoma kushandisa mushonga mutsva kana wajaira wekare. Asi kudzidza nezvemishonga mitsva inoshanda uye kutaura nachiremba wako nezvezvakanaka nezvakaipira kwakakosha zvikuru pahutano hwako.
Mharidzo Yekuenda Nayo Kumba
- ARNI mushonga unobudirira, wemazuva ano wakagadzirwa nemusanganiswa wemishonga miviri yekurapa kutadza kushanda kwemoyo.
- Izvi zvinotambanudza mitsipa yeropa, zvinobvisa munyu nemvura zvisingadiwi mumuviri, uye zvinoderedza mutoro pamwoyo.
- Mushonga uyu une mabhenefiti akawanda, anosanganisira kuwedzera hupenyu hwemurwere, kuvandudzwa kwehupenyu hwake, uye kudzikira kwekuiswa muchipatara.
- Mushonga uyu haukodzeri vakadzi vane pamuviri, avo vakambova ne angioedema, uye avo vane mamwe matambudziko ehutano.
- Migumisiro yakadai sedzungu uye BP yakaderera inogona kuitika. Saka, zvakakosha kugara uchitarisirwa nachiremba.
- Usambofa watanga kana kurega kutora mushonga uyu usina kupiwa mazano nachiremba. Kana uine matambudziko, taura nachiremba wako nekukasika.
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