Ingabe wena noma othile emndenini wakho unesifo senhliziyo? Uma kunjalo, cishe uhlala ukhathazekile ngemithi udokotela wakho ayinikezayo. Uma inhliziyo yakho izizwa ikhathele kancane, kubaluleke kakhulu ukuqaphela njalo imithi engayisiza. Namuhla sizokhuluma ngomuthi omusha oye wabonisa imiphumela ephumelelayo kakhulu ekwelapheni lesi simo. Leyo yi-ARNI.
Kalula nje, iyini i-ARNI?
I-ARNI empeleni iyinhlanganisela yemithi emibili. Igama layo eliphelele yi-Angiotensin Receptor/Neprilysin Inhibitor. Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, empeleni lilula kakhulu. Lenzelwe ukwelapha iziguli ezinesifo senhliziyo.
Izingxenye ezimbili eziyinhloko zalo muthi yilezi:
1. I-ARB (i-Angiotensin II Receptor Blocker): Umuthi 'i-Valsartan' ungowaleli qembu.
2. I-Neprilysin Inhibitor: Umuthi 'Sacubitril' ungowaleli qembu.
Umuthi we-ARNI kuphela otholakala emhlabeni ohlanganisa lezi ezimbili yi -Sacubitril/Valsartan . Lokhu kwavunywa ngo-2015.
Lo muthi usebenza kanjani emzimbeni?
Kulungile, manje ake sibone ukuthi le mithi emibili ingasiza kanjani inhliziyo yakho.
Cabanga ngemithambo yegazi emzimbeni wakho njengamapayipi athwala amanzi. Ngezinye izikhathi lawa mapayipi ayavaleka futhi abe mancane, okwenza kube nzima ngenhliziyo yakho ukupompa igazi.
- I-Valsartan (isigaba se-ARB): Lo muthi usebenza ngokukhulula nokwandisa imithambo yegazi emincane. Kufana nokwandisa ipayipi elivalekile. Ngemuva kwalokho igazi lingageleza emzimbeni wonke ngaphandle kokuvinjelwa. Lokhu kwehlisa umfutho wegazi.
- I-Sacubitril (I-Neprilysin Inhibitor): Lokhu kwenza into ebaluleke nakakhulu. Imizimba yethu ikhiqiza ngokwemvelo ama-hormone asiza izinhliziyo zethu. Kodwa i-enzyme ebizwa ngokuthi 'i-Neprilysin' ibhubhisa la ma-hormone amahle. I-Sacubitril iyayivimba leyo enzyme embi ukuthi isebenze. Uma ima, imizimba yethu ingenza okulandelayo:
- Susa i-sodium engadingekile (usawoti) emzimbeni ngomchamo.
- Yenza imithambo yegazi ibe banzi.
- Khiqiza umchamo omningi futhi unciphise uketshezi oluningi emzimbeni.
Kalula nje, ukuhlanganiswa kwale mithi emibili kunciphisa umthwalo enhliziyweni futhi kwenza umsebenzi wayo ube lula kakhulu. Kufana nokuba nabantu ababili abengeziwe abazosiza umuntu osebenza kanzima.
I-ARNI inconywa ngobani?
Lo muthi awufanele wonke umuntu. Udokotela wakho uzonquma ukuthi lo muthi ukulungele yini ngokusekelwe ezicini eziningana.
| Ukufaneleka | Incazelo |
|---|---|
| Kulabo abanekhono lokushaya inhliziyo elinciphile | Uma usanda kutholwa une-Heart Failure futhi i-Ejection Fraction (EF) yakho, isilinganiso sokusebenza kahle kwenhliziyo, ingu-40% noma ngaphansi (kumuntu ophilile, leli nani licishe libe ngu-55%-65%). |
| Kulabo abashintsha eminye imithi | Uma usuvele uthatha ama-ACE inhibitors noma ama-ARB ngenxa yokwehluleka kwenhliziyo, ungashintshela kuma-ARNI esikhundleni salokho. |
Kubaluleke kakhulu: Uma ushintsha kusuka ku-ACE inhibitor (isib. i-Enalapril, i-Lisinopril) uye ku-ARNI, linda amahora angu-36 ngemuva kokuyeka i-ACE inhibitor ngaphambi kokuqala i-ARNI. Ukwehluleka ukwenza kanjalo kungabangela ukusabela okuyingozi kokungezwani komzimba (i-angioedema), okuwukuvuvukala ngaphansi kwesikhumba. Udokotela wakho uzokweluleka ngalokhu.
Izinzuzo ze-ARNI nezizathu zokuyisebenzisa
Abantu abaningi bashintshela kuma-ARNI ngenxa yemiphumela emibi, njengokukhwehlela okuqhubekayo, ehambisana nemithi emidala efana ne-ACE inhibitors. Kodwa akusona ukuphela kwesizathu. Kunezinzuzo eziningi zokusebenzisa ama-ARNI.
- Kwandisa isikhathi sokuphila: Izifundo zithole ukuthi lo muthi unciphisa ingozi yokufa okuhlobene nesifo senhliziyo.
- Kuthuthukisa ikhwalithi yokuphila: Kunciphisa izimpawu ezifana nokukhathala nokukhathala, kukusiza ukuthi usebenze kahle.
- Ilawula ukuqhubeka kwesifo: Yehlisa izinga lokwehluleka kwenhliziyo okuba kubi kakhulu.
- Kunciphisa ukulaliswa esibhedlela: Kuye kwafakazelwa ukuthi abantu abaphuza lo muthi banamathuba amancane okulaliswa esibhedlela ngenxa yokwehluleka kwenhliziyo.
- Kuthuthukisa ukusebenza kwenhliziyo: Ucwaningo olulodwa lubonise ukuthi ngemva kokuthatha i-ARNI unyaka wonke, ingxenye yokukhipha isiguli yanda isuka ku-28% yaya ku-38%. Lokhu kusho ukuthi ikhono lokushaya kwenhliziyo lathuthuka kakhulu.
Ngokusho kocwaningo olukhulu, abantu abathatha i-ARNI banengozi encishisiwe engu-20% yokufa noma yokulaliswa esibhedlela ngenxa yesifo senhliziyo.
Ubani okungafanele asebenzise lo muthi?
Lomuthi awufanele abanye abantu. Uma ungomunye walaba bantu, odokotela bathi akufanele uwuthathe lo muthi.
| Isimo | Isizathu |
|---|---|
| Omama abakhulelwe noma abancelisayo | Ngoba kungalimaza ingane. |
| Abantu abake baba ne-angioedema ngaphambilini | Uma uke waba ne-angioedema ngaphambilini, ukuvuvukala kobuso noma kwezindebe, ngenxa ye-ACE inhibitor noma umuthi we-ARB. |
| Labo asebevele bethatha i-ACE inhibitor/ARB | Kuyingozi ukuphuza imithi yomibili kanyekanye. |
| Abantu abanesifo sesibindi esibi kakhulu | Lo muthi awufaneleki uma ungasebenzi kahle kwesibindi. |
| Abantu abathatha i-Aliskiren | Akukhuthazwa ukuthatha i-ARNI uma uthatha i-Aliskiren enesifo sikashukela noma isifo sezinso. |
Ake sifunde nangemiphumela emibi.
Njenganoma yimuphi umuthi, i-ARNI ingabangela imiphumela emibi emincane. Kodwa-ke, akuwona wonke umuntu oyitholayo.
- Umfutho wegazi ophansi (Hypotension): Ungase uzizwe unesiyezi futhi uzizwa ukhathele.
- Imiphumela ekusebenzeni kwezinso: Abanye abantu bangase babhekane nokwehla okuncane kokusebenza kwezinso.
- Amazinga e-potassium akhuphukile egazini (i-Hyperkalemia): Lokhu kungenzeka nakwabanye abantu.
- I-Angioedema: Ukuvuvukala kobuso, izindebe, nolimi. Lokhu akuvamile kakhulu , kodwa kungaba yingozi kakhulu uma kwenzeka.
Yingakho udokotela wakho ezohlola igazi lakho (ukuze ahlole amazinga ezinso zakho kanye ne-potassium) kanye nomfutho wegazi emasontweni ambalwa okuqala uma uqala ukuthatha lo muthi. Uma kukhona izinkinga, udokotela wakho uzonciphisa umthamo noma akutshele ukuthi wenzeni. Ungalokothi uyeke ukuthatha lo muthi ngaphandle kweseluleko sikadokotela wakho.
Le miphumela emibi ivame ukuphela zingakapheli amasonto amabili. Uma iqhubeka, yazisa udokotela wakho ngokushesha.
Kufanele ngimbone nini udokotela?
Uma uhlangabezana nanoma yiziphi zalezi zimpawu ngenkathi usebenzisa i-ARNI, qiniseka ukuthi ukhuluma nodokotela wakho.
- isiyezi esivamile
- Ubuhlanya
- Ngezinye izikhathi ukuquleka
- Umfutho wegazi ophansi kakhulu (uma ukufundwa kwe-systolic kungaphansi kwama-90)
Ungase wesabe kancane ukushintshela emithini emisha uma usujwayele endala. Kodwa ukufunda ngemithi emisha nephumelelayo nokukhuluma nodokotela wakho ngezinzuzo nezingozi zayo kubaluleke kakhulu empilweni yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-ARNI iwumuthi wesimanje ophumelelayo nowakhiwe ngenhlanganisela yemithi emibili yokwelapha ukwehluleka kwenhliziyo.
- Lokhu kwandisa imithambo yegazi, kususe usawoti namanzi okungadingekile emzimbeni, futhi kunciphisa umthwalo enhliziyweni.
- Lomuthi unikeza izinzuzo eziningi, okuhlanganisa nokukhula kwesikhathi sokuphila, ikhwalithi yokuphila ethuthukisiwe, kanye nokuncipha kokulaliswa esibhedlela.
- Lo muthi awufanele abesifazane abakhulelwe, labo abake baba ne-angioedema ngaphambilini, kanye nalabo abanezinye izimo zezokwelapha.
- Imiphumela emibi efana nokuzungeza kanye nomfutho wegazi ophansi ingase ibe khona. Ngakho-ke, kubalulekile ukuba ngaphansi kokuqashwa njalo ngudokotela.
- Ungalokothi uqale noma uyeke ukuthatha lo muthi ngaphandle kweseluleko sezokwelapha. Uma unezinkinga, xhumana nodokotela wakho ngokushesha.
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