Kwamanye, i-ACE inhibitors njenge-lisinopril imbangela yokukhwehlela nokuvuvukala.
I-Angiotensin-ukuguqula i-enzyme inhibitors (i-ACE inhibitors) njenge-lisinopril, i-captopril kanye ne-enalapril yimithi yokwelapha. Ama-inhibitors e-ACE asebenza kahle ekunciphiseni ukucindezelwa kwegazi futhi avame ukukhetha kwezinye izinto ezifana ne-beta-blockers (cabanga nge-propanolol). Noma kunjalo, abanye abantu abakwi-ACE inhibitors bahlakulela ukukhwehlela okomile okweqisayo noma ukuvuvukala okwenziwe okwenziwe, ubuso nomlomo (angioedema) okwenza ukuthatha le mithi kunzima noma ngisho nokubulala.
Yiziphi izivimbela i-ACE?
I-ACE inhibitors ivimbela i-angiotensin-eguqulela i-enzyme eguqulela i-angiotensin I nge-angiotensin II. Ngokuvimbela lesi sinyathelo esidingekayo ohlelweni lwe-renin-angiotensin , ama-inhibitors e-ACE akwazi ukunciphisa ukucindezelwa kwegazi nge-vasoconstriction nokukhubazeka komsebenzi we-aldosterone.
I-Aldosterone iyi-hormone ye-steroid (i-mineralocorticoid) ekhishwe yizigulane ze-adrenal (zona glomerulosa), ezihlala ziphezu kwezinso zakho. I-Aldosterone ilawula ukuhlunga komchamo nge-nephrononi yezinso. Ngokuqondile, i-aldosterone isebenza ukuletha i-sodium namanzi ekujikelezeni kwakho ngokushintshanisa i-potassium ekhishwa futhi iguqulwe ngaphandle. Inothi, njengoba lichazwe imithetho ye-osmosis, igcinwe i-sodium namanzi ukwandisa umfutho wegazi.
Nazi ezinye izibonelo ze-ACE inhibitors:
- lisinopril
- i-captopril
- i-perindopril
- i-enalapril
- benazepril
- i-fosinopril
Ama-inhibitors e-ACE afana ne-lisinopril asetshenziselwa ukwelapha umfutho wegazi ophezulu noma umfutho wegazi ophezulu futhi asebenza ngokukhethekile kulabo bantu abanesifo esingenasifo sezinso nokuhluleka kwenhliziyo.
Ama-inhibitors e-ACE asetshenziselwa ukwelashwa kwesifo sohlangothi, ukuhlaselwa yinhliziyo, ukuhluleka kwenhliziyo nokuvimbela izenzakalo ze-cardiovascular ezizayo. Kumele kuqashelwe ukuthi ngomqondo ovamile, i-ACE inhibitors-njengeminye imishanguzo yokulwa negciwane-ayisebenzisi kangcono ekunciphiseni ukucindezelwa kwegazi nokuvimbela ukuqhuma okuqhubekayo nokushaya kwenhliziyo kwabase-Afrika baseMelika.
Ngokuyinhloko, i-ACE inhibitors iphephile futhi ibekezeleleke kahle. Uma kuthathwe ngokweqile, noma kunjalo, i-ACE inhibitors ibangela ukunganaki noma umfutho wegazi ophansi ngokuyingozi futhi unciphisa inhliziyo yakho (bradycardia), futhi. Lapho umuntu eba nomfutho wegazi ophansi kakhulu oya ku-ACE inhibitors, i-ACE inhibitor inqanyuliwe futhi kusetshenziselwa uketshezi ukuletha izingcindezi emuva. (Abacindezeli ngokuvamile abadingekile ukuvuselela ukucindezelwa kwegazi okuyisisekelo.)
Kulabo abanokukhubazeka ngokweqile noma kulabo abathatha ama-NSAID (izidakamizwa ezinjenge-aspirin), i-ACE inhibitors ingahle ihlekise amazinga omzimba wakho osawoti ophumela hyperkalemia noma amazinga amaningi kakhulu we-potassium . I-Hyperkalemia imbi ngoba ihlukumeza inhliziyo yakho futhi ingakubulala. Ngemuva kokuyeka ngokushesha kwe-ACE inhibitor, i-hyperkalemia enjalo iphathwa esibhedlela isebenzisa izidakamizwa njenge-calcium, i-insulini kanye ne-glucose njalonjalo.
I-ACE Inhibitors, i-Angioedema, ne-Cough
Ngaphansi kwezimo ezivamile, i-enzyme yokuguqula i-angiotensin idiliza i-bradykinin, umlamuleli ovuthayo ocatshangelwa ukuthi uyimbangela yokukhwehlela owomile nokuvuvukala okubonwe cishe ngamaphesenti angu-25 alabo abathatha ama-lisinopril namanye ama-ACE inhibitors. Ukuphendula okunjalo kuvame kakhulu kubantu base-Afrika baseMelika
Kulabo abahlakulela i-angioedema, isenzo se-allergic-reaction, i-ACE inhibitor isuswa ngokushesha futhi i-steroids ne-diphenhydramine (Benadryl) inikezwa ukulawula ukuvuvukala. Ukuvuvukala okunjalo kungaba yisidingo esiphuthumayo sezokwelapha ngoba singavimbela umoya wakho futhi kungenzeka noma nini ngenkathi ku-ACE inhibitors. Ngamanye amazwi, ungathatha ama-inhibitors e-ACE isikhathi esithile ngaphambi kokuba ufunde i-angioedema.
Ukukhwehlela okubangelwa ama-inhibitors e-ACE akudingi ukwelashwa ngaphandle kokunqamuka kwezidakamizwa. Ama-inhibitors e-ACE anesigamu esincane kakhulu sempilo kanye nomthamo ophansi wokusabalalisa futhi kufanele ahlanze ngaphandle kwakho ngosuku.
Uma wena noma othandekayo uthatha i-ACE inhibitor njengo-lisinopril futhi uthola ukukhwehlela, sicela uzinike isikhathi sokubona udokotela wakho wokuhlola. Udokotela wakho cishe uzoyeka i-ACE inhibitor bese uqala kwenye imithi elwa nama-antihypertensive njenge-ARB (i-angiotensin II receptor blocker).
Uma wena noma othandekayo uhlangabezana ne-angioedema nokuvuvukala kokuphila ngenkathi ku-ACE inhibitor, ungathathi imithi futhi ngokushesha ubize u-911. Ngemuva kokwelashwa nge-steroids no-Benadryl, udokotela wakho angakuhlola futhi akunike esinye isidakamizwa somfutho wegazi ophezulu . Sicela uqaphele ukuthi lesi sidakamizwa cishe ngeke sibe i-ARB ngoba ama-ARB ayaziwa ngokungajwayelekile ukuthi angabangela i-angioedema, futhi.
Encwadini yokugcina, ezinye izimo ezimbi ezibangelwa ama-inhibitors e-ACE njengegazi eliphansi ngokweqile nokucindezeleka kwegazi (i-hyperkalemia) ngokuvamile kubangelwa ukungenelela ngokweqile, imithi (i-NSAID) noma umsebenzi wezinso okhubazekile oguqula imvume. Ngakho-ke, ngenkathi uthatha i-ACE inhibitors, qinisekisa ukuqapha njalo umfutho wegazi lakho, ulandele udokotela wakho futhi uxhumane nodokotela wakho uma uzizwa unesihlungi, uhlose ukukhanya, udizizi noma njalo.
Imithombo
Atkins G, Rahman M, Wright JT, Jr. Isahluko 70. Ukuxilongwa Nokuphathwa Kwe-Hypertension. Ku: Fuster V, Walsh RA, Harrington RA. ama-eds. Lalela Funda Kudivayisi kuphela Kwengeziwe ENew York, NY: McGraw-Hill; 2011. Kufinyelelwe ngo-Ephreli 18, 2015.
Hayashi SA. Isahluko 10. I-Angiotensin Blockers ne-ACE Inhibitors. Ku: Olson KR. ama-eds. Ukushisa nokudlulela kwezidakamizwa, 6e . ENew York, NY: McGraw-Hill; 2012. Kufinyelelwe ngo-Ephreli 18, 2015.