Mu zina, ACE inhibitors monga mankhwala chifukwa chifuwa ndi kutupa.
Angiotensin-kutembenuza ma enzyme inhibitors (ACE inhibitors) monga mankhwalawa, captopril ndi enalapril ndi mankhwala osokoneza bongo. ACE inhibitors amathandiza kuchepetsa kuthamanga kwa magazi ndipo nthawi zambiri amasankha zinthu zina monga beta-blockers (kuganiza propanolol). Komabe, anthu ena pa ACE inhibitors amakhala ndi chifuwa chowopsya kapena kutentha kwa nkhope, pakamwa ndi m'chinenero (angioedema) zomwe zimapangitsa kumwa mankhwalawa kukhala ovuta kapena opha.
Kodi ACE Inhibitors Ndi Chiyani?
ACE inhibitors amachititsa kuti tizilombo toyambitsa matenda a angiotensin omwe amachititsa kuti angiotensin ine ndi angiotensin II ikhale. Mwa kulepheretsa sitepe yofunikirayi mu njira ya renin-angiotensin , ACE inhibitors amatha kuchepetsa kuthamanga kwa magazi kupyolera muzitsulo komanso kupweteka kwa ntchito ya aldosterone.
Aldosterone ndi horroone (mineralocorticoid) yomwe imapangidwa ndi adrenal glands (zona glomerulosa), yomwe imakhala pamwamba pa impso zanu. Aldosterone imayendetsa kusuta kwa mkodzo ndi nephrons za impso. Mwapadera, aldosterone amagwira ntchito kuti abweretse sodium ndi madzi kuti aziyenda pozungulira potaziyamu yomwe imachotsedwa. Zindikirani, monga mwa lamulo la osmosis, adasunga sodium ndi madzi kuwonjezera mphamvu ya magazi.
Nazi zitsanzo za ACE inhibitors:
- lisinopril
- captopril
- perindopril
- enalapril
- benazepril
- fosinopril
ACE inhibitors monga lisinopril amagwiritsidwa ntchito pochiza matenda oopsa kwambiri kapena kuthamanga kwa magazi ndipo amathandiza kwambiri anthu omwe ali ndi matenda a impso komanso mtima wosalimba.
ACE inhibitors amagwiritsidwanso ntchito pochiza matenda, kupweteka kwa mtima, kulephera mtima komanso kupeŵa zochitika zamtsogolo za mtima. Tiyenera kukumbukira kuti mwachidziwitso, ACE inhibitors-monga mankhwala ena opatsirana kwambiri-sagwira bwino kuchepetsa kuthamanga kwa magazi ndi kupeŵa kupwetekedwa ndi kupweteka kwa mtima ku Afirika America.
Kawirikawiri, ACE inhibitors ndi otetezeka komanso olekerera. Ngati atengedwa mopitirira muyeso, aCE inhibitors amachititsa kuti asakanike kapena kuthamanga kwa magazi mofulumira komanso kuchepetsa mtima wako (bradycardia), nayenso. Munthu akayamba kuthamanga kwambiri kwa magazi a ACE inhibitors, ACE inhibitor imatha ndipo madzi amaperekedwa kuti abweretse mavuto. (Osavuta nthawi zambiri sakufunika kuti abwezeretsenso mphamvu yoyamba ya magazi.)
Kwa iwo omwe ali ndi vuto lachibwibwi kapena omwe amatenga NSAIDs (mankhwala monga aspirin), ACE inhibitors angasokonezenso mawere a thupi lanu omwe amachititsa hyperkalemia kapena mavitamini owonjezera . Hyperkalemia ndizoipa chifukwa zimasokoneza mtima wanu kumenya ndipo zingakuphe. Pambuyo pakutha kwa ACE inhibitor, hyperkalemia imeneyi imachiritsidwa kuchipatala pogwiritsa ntchito mankhwala monga calcium, insulini komanso shuga ndi zina zotero.
ACE Inhibitors, Angioedema, ndi Cough
Nthawi zambiri, mavitamini otembenuza angiotensin amathyola bradykinin, mkhalapakati wotupa omwe amawoneka kuti ndi amene amachititsa chifuwa chouma ndi kutupa komwe kumawoneka pafupifupi 25 peresenti ya iwo omwe amatenga lisinopril ndi ena ACE inhibitors. Kuchita koteroko kuli kofala kwambiri ku anthu a ku America
Kwa iwo omwe amayamba angioedema, omwe amachititsa kuti ayambe kuchita, ACE inhibitor imatha nthawi yomweyo ndipo steroids ndi diphenhydramine (Benadryl) zimapatsidwa mphamvu zowononga kutupa. Kutupa koteroko kungakhale kofulumira kwachipatala chifukwa kungakulepheretseni ulendo wanu ndipo nthawi iliyonse ikafika pa ACE inhibitors. Mwa kuyankhula kwina, mutha kutenga ACE inhibitors kwa nthawi ndithu musanayambe angioedema.
Chifuwa choyambitsidwa ndi ACE inhibitors sichiyenera kupatsidwa chithandizo kupatula kuleka kwa mankhwala. ACE inhibitors ali ndi theka la moyo waufupi komanso wochepa wogawa ndipo ayenera kusamba mkati mwa tsiku limodzi.
Ngati inu kapena wokondedwa mukutsata ACE inhibitor ngati lisinopril ndikukumana ndi chifuwa, chonde pempheni nthawi yoti muwone dokotala wanu. Dokotala wanu akhoza kusiya ACE inhibitor ndikuyambitsanso mankhwala ena olimbana ndi mphamvu ngati ARB (blocker ya angiotensin II receptor).
Ngati inu kapena wokondedwa wanu muli ndi vuto la angioedema ndi kuopseza moyo panthawi ya ACE inhibitor, musamamwe mankhwala ena ndipo nthawi yomweyo muitaneni 911. Pambuyo pa mankhwala ndi steroids ndi Benadryl, dokotala wanu akhoza kukuyang'anirani ndikukupatsani mankhwala ena a matenda oopsa . Chonde dziwani kuti mankhwalawa sangakhale ARB chifukwa mabungwe a ARB amadziwika kuti sangayambitse angioedema, nayenso.
Pamapeto pake, zotsatira zina zoipa zomwe zimayambitsidwa ndi ACE zowonongeka monga kupweteka kwa magazi komanso kuchepa kwa magazi (hyperkalemia) kawirikawiri zimayambitsanso kuyanjana, kumwa mankhwala (NSAID) kapena ntchito yovuta ya impso yomwe imasintha. Choncho, pamene mutenga ACE inhibitors, onetsetsani kuti mumayang'anitsitsa kupanikizika kwanu kwa magazi, kutsatirani ndi dokotala wanu ndikumankhulana ndi dokotala wanu ngati mumamva kuti ndiwanyansidwa, wotsogola, wamzungu, kapena zina zotero.
Zotsatira
Atkins G, Rahman M, Wright JT, Jr. Chaputala 70. Kuzindikira ndi Chithandizo cha Kuthamanga kwa Mthupi. Mu: Fuster V, Walsh RA, Harrington RA. eds. Mtima Wopweteka, 13 . New York, NY: Hill ya McGraw; 2011. Kufikira pa April 18, 2015.
Hayashi SA. Mutu 10. Angiotensin Blockers ndi ACE Inhibitors. Mu: Olson KR. eds. Kuchepetsa & Kudyetsa Mankhwala Osokoneza Bongo, 6e . New York, NY: Hill ya McGraw; 2012. Kupezeka pa April 18, 2015.