Ingabe ukhathazekile ngamahlule egazi? Ungase ukhathazeke ngokuba nesifo senhliziyo noma isifo sohlangothi. Kubantu abasengozini, odokotela banikeza uhlobo lomuthi owaziwa ngokuthi "umuthi wokunciphisa igazi." Ngakho-ke namuhla sizokhuluma ngohlobo olusha, kodwa olubaluleke kakhulu, lomuthi. Lokho yi-Direct Thrombin Inhibitors.
Kalula nje, ziyini lezi Zithibithi Ze-Direct Thrombin?
Lezi yizidakamizwa esizibiza ngokuthi imithi yokunciphisa igazi, noma imithi yokunciphisa igazi ngokwezokwelapha. Umsebenzi wazo ukuvimba ukwakheka okungadingekile kwamahlule egazini emzimbeni. Cabanga nje, abantu abaningi emhlabeni bafa ngenxa yesifo senhliziyo. Ngakho-ke lezi zinhlobo zemithi ziwusizo kakhulu ekuvimbeleni amahlule egazini ukuthi angavali imithambo yegazi ehlinzeka ngezitho ezibalulekile njengenhliziyo nobuchopho.
Nakuba esikhathini esidlule, le mithi yayenziwa kusetshenziswa izinto ezifana neprotheyini etholakala ematheni ezimpungushe, imithi yesimanje ekhiqizwa emalabhorethri manje iyasetshenziswa.
Lo muthi usetshenziselwa ziphi izimo?
Odokotela batusa lolu hlobo lomuthi, olubizwa ngokuthi ama-direct thrombin inhibitors, ukuvimbela nokulawula izimo eziningi. Ake sibheke ithebula elifana naleli ukuze lolu lwazi lube lula ukuluqonda.
| Isimo | Incazelo elula |
|---|---|
| I-Acute Coronary Syndrome | Ukwehla noma ukumiswa kokugeleza kwegazi ngokuzumayo ngenxa yokuvaleka komthambo othwala igazi uye enhliziyweni. |
| I-Thrombocytopenia ebangelwa yi-Heparin (HIT) | Isimo esiyinkimbinkimbi lapho i-heparin encane egazini ibangela ukwehla kwama-platelet, okuholela ekwakhekeni kwama-blood clots. |
| I-VTE (i-VTE) ye-Thromboembolism yemithambo yegazi | Kuvela ihlule legazi bese linamathela emthanjeni emzimbeni. |
| Ukuvimbela Isifo Sohlangothi Ekushayweni Yi-Atrial Fibrillation (Afib) | Vimbela isifo sohlangothi ezigulini ezingenazo izinkinga ze-valve yenhliziyo kodwa ezinezinhliziyo ezishaya ngokungajwayelekile (i-Afib). |
| Ngemva kokuhlinzwa kokufakelwa inqulu | Nciphisa ingozi yokuqhekeka kwegazi emilenzeni ngemva kokuhlinzwa. |
| I-Deep Vein Thrombosis (DVT) | Ihlule legazi, ikakhulukazi emthanjeni ojulile emilenzeni. |
| I-Pulmonary Embolism | Ihlule legazi emlenzeni liyaqhekeka bese lihlala emthanjeni emaphashini. |
Ngaphezu kwalokho, lo muthi unikezwa njengomjovo ngesikhathi sokwelashwa okufana ne-angioplasty, okuvula imithambo yegazi enhliziyweni.
Lo muthi usebenza kanjani emzimbeni?
Lokhu kulula kakhulu ukukuqonda. Kunezinto eziningi ezihilelekile enkambisweni yokujiya kwegazi emzimbeni wethu. Phakathi kwazo , "i-Thrombin" ifana nonjiniyela oyinhloko wefektri yokujiya kwegazi. Nguye onikeza imiyalo yenqubo yokujiya kwegazi.
Ngakho-ke lokho okwenziwa yi-Direct Thrombin Inhibitor ukuthi ibopha ngqo kuleyo nto ebizwa ngokuthi i-thrombin futhi iyivimbe ekwenzeni umsebenzi wayo. Kufana nomuntu ogxuma phambi komshini wokwenza amahlule egazi futhi aphazamise umsebenzi wakhe. Lapho i-thrombin iyeka ukusebenza, yonke inqubo yokwakheka kwamahlule egazi iyayeka.
Kodwa ngezinye izikhathi lo muthi ungabangela ukopha ngokweqile. Ezimweni ezinjalo, kuba nomjovo obizwa ngokuthi i-Idarucizumab ukuze kulungiswe imiphumela yephilisi ebizwa ngokuthi i-Dabigatran . Kodwa-ke, ayikho ikhambi eliqondile lemithi ye-intravenous (IV). Kodwa-ke, uma umuthi usuyekiwe, imiphumela yawo iyaphela emzimbeni ngokuhamba kwesikhathi.
Ziyini izinzuzo zalo muthi?
Uma kuqhathaniswa nemithi yokwehlisa igazi endala, lolu hlobo olusha lomuthi lunezinzuzo eziningana.
- Imiphumela icacile kakhulu:Ngenxa yokuthi lo muthi ubopha kuphela ku-thrombin, imiphumela iyafana kakhulu. Lokhu kusho ukuthi ungalindela imiphumela efanayo njalo uma uthatha umthamo ofanayo. Akudingeki ushintshe umthamo kaningi njengoba ubungenza nge-warfarin.
- Akunciphisi ama-platelet egazi: Lokhu akunciphisi ama-platelet egazi njengeminye imithi.
- Asikho isidingo sokuhlolwa kwegazi njalo: Uma uthatha i-Warfarin, udinga ukuhlolwa kwegazi njalo ukuze uhlole izinga lokujiya kwegazi lakho (ukuhlolwa kwe-INR). Kodwa lo muthi awudingi lokho.
- Ingozi ephansi kanye nokulula: I-Dabigatran, ethathwa njengephilisi, inengozi ephansi yokopha uma iqhathaniswa ne-Warfarin. Iphinde ibe nokuxhumana okuncane neminye imithi. Ilula kakhulu ukuyisebenzisa ngoba ingathathwa kanye noma kabili ngosuku.
- Inketho enhle: Lena inketho enhle kulabo abangakwazi ukuthatha umuthi i-Heparin.
Lo muthi usebenza kahle kangakanani? Ingabe kukhona ingozi?
Ucwaningo lukhombisile ukuthi lo muthi uphephile futhi usebenza kahle njengeWarfarin noma iHeparin. Kodwa-ke, kunesixwayiso esisodwa esibalulekile. Lo muthi awufanele abantu abane-valve yenhliziyo yomshini. Udokotela wakho uzokweluleka ngalokhu.
Umehluko omkhulu kule mithi ukuthi ihlala emzimbeni isikhathi esifushane.
Cabanga nje, uma uthatha umthamo we-Warfarin, cishe ingxenye yawo ingahlala emzimbeni wakho amahora angama-20-60. Kodwa uma uthatha umuthi ofana ne-Dabigatran, ingxenye yawo iphuma emzimbeni wakho emahoreni ayi-12-14.
Into ebaluleke kakhulu okudingeka siyiqonde kulokhu ukuthi akuwona umqondo omuhle ukweqa umthamo wemithi nganoma yisiphi isizathu . Uma uphuthelwa umthamo, umphumela womuthi uzophela ngokushesha, futhi ingozi yokuba negazi elijiyile inganda ngokuzumayo.
Yimiphi imiphumela emibi kanye nezinkinga ezingaba khona?
Njenganoma yimuphi umuthi, lokhu kungaba nemiphumela emibi. Nakuba eminye ivamile, eminye idinga ukuba siqaphele kakhulu.
Umphumela oyinhloko noyingozi kakhulu ukopha ngokweqile (Izinkinga zokopha). Ngaphezu kwalokho, okulandelayo kungenzeka:
- Ukungakhululeki kwesisu, ukuvuvukala (i-Dyspepsia)
- Isisu esibuhlungu
- Umchamo onsundu noma opinki
- Ikhanda elibuhlungu
- Umfutho wegazi ophansi (i-Hypotension)
- Ubuhlungu besifuba
- Isiyezi
- Ubunzima bokuphefumula
- Imfiva
- I-Sepsis (ukusabela okukhulu komzimba ekuthelelekeni)
- Ukuboshwa kwenhliziyo
Kufanele ngimshayele nini udokotela?
Uma uhlangabezana nanoma yimiphi imiphumela emibi ngenkathi usebenzisa lo muthi, yazisa udokotela wakho ngokushesha.
Ikakhulukazi uma kunezimpawu zokopha kakhulu, kuyisimo esiphuthumayo.Isibonelo, uma inxeba lingayeki ukuphuma kwegazi, uma indle yakho imnyama, uma uhlanza igazi, noma uma uphathwa yikhanda elibuhlungu, hamba ngokushesha eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze. Ungalibali.
Umlayezo Wokuya Nawe Ekhaya
- Ama-Direct Thrombin Inhibitors uhlobo lomuthi olunamandla kakhulu oluvimbela ukujiya kwegazi. Njalo thatha umthamo oshiwo udokotela wakho, ngesikhathi esifanele.
- Ungayeki umthamo wemithi nganoma yisiphi isizathu. Ukwenza kanjalo kwandisa ingozi yokuqhekeka kwegazi. Uma ukhohlwa ukuthatha umthamo, buza udokotela wakho ngokushesha ukuthi yini okufanele uyenze ngokulandelayo.
- Qaphela izimpawu zokopha kakhulu (indle emnyama, igazi elihlanzayo, ukopha okuqhubekayo). Uma lokhu kwenzeka, iya ku-ETU ngokushesha.
- Lo muthi awufanele wonke umuntu (ikakhulukazi labo abane-valve yenhliziyo yomshini), ngakho qiniseka ukuthi utshela udokotela wakho umlando wakho wezokwelapha ogcwele.
- Uma uthola olunye ukwelashwa (ngisho nokukhishwa kwezinyo), yazisa udokotela ukuthi uthatha lo muthi.
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