Ukudla, imishanguzo futhi kuthinta kakhulu imithi ye-warfarin
Uma uye waphathwa nge- thrombosis ejulile , ungalindela okungenani izinyanga ezintathu ze-anticoagulants noma imithi yokwelapha igazi ngemuva kokuphuma esibhedlela.
I-thrombosis ejulile yingozi iyingozi lapho umzimba wakho udala i-clot, ngokuvamile emlenzeni, ongaphonsa amanye ama-clots angase avimbele ukusakaza emaphashini akho.
Lo mcimbi obulalayo uyaziwa ngokuthi embolism yamaphalenda. Njengoba uphethwe i-anticoagulant therapy ngemuva kokuphuma esibhedlela, unciphisa ingozi yokuguqula ama-clots egazi abulalayo. Ngokuphawula, ukuphathwa kwe-anticoagulant akunikezwa nje nge-thrombosis ejulile. Isibonelo, uma okwamanje uphathwa nge-stroke noma isimo esithile se-hypercoagulable, ungalindela isikhathi sokuphila se-anticoagulation.
I-Anticoagulation ingagcinwa imithi eminingana ehlanganisa i-heparin encane-isisindo somzimba (i-subcutaneous injection), i-fondaparinux (injection yangaphakathi) noma i-oral Xa inhibitors njenge-dabigatran. Kulesi sihloko, sizogxila ku-warfarin (i-Coumadin) evame ukutholakala njengemithi yomlomo. Uma ukhetha ukwelashwa kwe-anticoagulant, sicela uhlale ukhumbule ukuthi izinketho zikhona, futhi udokotela wakho angakwazi ukuxoxa ngalezi zindlela nawe.
Indlela iWarfarin isebenza ngayo
I-Warfarin iphazamisa ukucubungula kwezinto eziqhakazile okuyi-vitamin K-encike kuyo, ngaleyo ndlela ihlukumeza inqubo yokugcoba nokuvimbela ukwakheka kwanoma yiziphi izindwangu ezintsha.
Kuze kube yilapho ihlala khona, i-warfarin ihlanganiswe nge-parentrenal or anticoagulant engenalutho njengoLovenox (injection enoxaparin).
I-Warfarin itholakale kokubili okulungiselelwe ngomlomo nangokwemvelo-abantu abaningi bathatha i-warfarin yomlomo. Abantu baqala cishe ngo-5 mg we-warfarin ngosuku ngezinsuku ezimbalwa zokuqala. I-Warfarin dose ishintshwe ukuze kugcinwe amazinga we-INR, izinyathelo zesimo se-coagulation engizithinta kancane kancane, ukwelapha.
Uma unesithakazelo, i-website www.warfarindosing.org inikeza wokubala yamahhala we-warfarin-dose.
Obani Abadinga Amanani Aphezulu?
Amanani aphezulu e-warfarin angadingeka ukuze kube neziguli ezilandelayo zesiguli:
- I-African American
- Kulungile
- I-Hypothyroid
- Utshwala luncike ekudleni
Obani Abadingayo Amanani Aphansi?
Ngakolunye uhlangothi, lezi ziguli ezilandelayo zesiguli kumele zithole amanani aphansi we-warfarin:
- Ekhulile
- I-asiya
- Hyperthyroid
- Ukuhluleka kwenhliziyo
- Isifo sesibindi
- Umlando wokuhlinzwa okukhulu
- I-polymorphisms ku-CYP2C9 noma i-VKORC1 gesi
Ngaphezu kwezici zesibalo esingenhla, izilonda ze-warfarin zibuye zishintshwe kuye ngemithi oyithathayo. Isibonelo, i-phenytoin yandisa isenzo se-warfarin futhi ngaleyo ndlela inciphisa amazinga we-INR.
Isilinganiso se-laboratory INR (isilinganiso somhlaba jikelele esimisiwe) sisetshenziselwa ukucacisa isimo sakho se-coagulation futhi ulungise umthamo wakho we-warfarin. Kubantu abaningi, amazinga ajwayelekile we-INR avela ku-0.8 kuya ku-1.2. Abantu e-warfarin ngokuvamile bagcinwa ngezinga le-INR phakathi kuka-2 no-3, okusho ukuthi lezi ziguli zithathwa kakhulu (zibe negazi elincane) kunabantu abavamile. Ngesikhathi uthola i-antiticoagulation, amazinga e-INR kufanele ahlolwe njalo ngudokotela wakho.
Indlela Ukudla Okuthinta Isilinganiso
Ngenxa yokuthi i-warfarin iyinhlangano ye-vitamin K, ukudla okunevithamini K kunganciphisa izinga lakho le-INR.
Ngokukodwa, imifino eluhlaza kanye namagqabhagqabha afana ne-vitamin K ephezulu. Ngakolunye uhlangothi, amazambane, izithelo, kanye nezitshalo ziphansi kakhulu ku-vitamin K. Ungakwazi ukuqhubeka nokudla izingxenye ezinomsoco wezimila eziluhlaza kanye namagatsha, kodwa-ke, zama ukuhlala ungaguquki ekusebenziseni kwakho kwansuku zonke ukuze amazinga akho e-INR angashintshi.
Izingozi
Imiphumela emibi ye-warfarin therapy ngokuvamile ikhawulwa yisicashu, izigqoko nokunye okunye. Kodwa-ke, i-warfarin yandisa ingozi yokugaya igazi noma ukuphuma kwegazi okungaba yingozi ngempela (cabanga ukuthi ubuchopho buphulukile). Uma kwenzeka isifo esibi kakhulu ngenxa yokwelapha nge-warfarin, odokotela bangakwazi ukuphatha i-vitamin K ukuze basize ukugcoba noma ukugcoba igazi.
Abantu abanomlando wokugaya igazi kufanele baqaphele lapho bethatha i-warfarin. Ngaphezu kwalokho, uma uthatha i-warfarin, kungcono ukusebenzisa i-razor kagesi nama-toothbrush kagesi ukuze unciphise ingozi yokuphuma. Futhi, qiniseka ukuthi utshele udokotela wamazinyo ukuthi use-warfarin ngaphambi kokuba noma yimuphi umsebenzi wamazinyo usuqedile.
Ngenxa yokuthi i-warfarin ingaxhumana nezidakamizwa ezihlukahlukene futhi iphonsa amazinga akho e-INR ekudleni, kungcono ukuthi ugweme imithi engaphezu kwe-counter noma i-herbal supplements ngenkathi kule mithi.
Uma wena noma othandekayo kudingeka uthathe i-warfarin ngenkinga ejulile ye-thrombosis, i-stroke, noma isimo se-hypercoagulable, sicela ukhumbule ukuthi ukwelashwa kwe-anticoagulant nalesi sidakamizwa yinqubo ehilelekile. Ukuze usungula futhi ugcine isimo esifanele se-anticoagulation, kuzodingeka usebenze eduze nodokotela wakho futhi mhlawumbe u-dietitian, futhi. Sicela ukhumbule ukuthi uhlale uqaphile, thola amazinga akho e-INR ahlolwe njalo, asebenze nethimba lakho lokunakekelwa kwezempilo, futhi ubuke ngokucophelela ukudla kwakho.
> Imithombo:
> Fogarty PF, Minichiello T. Ukuphazamiseka kweHemostasis, Thrombosis, & Therapy Antithrombotic. Ku: Papadakis MA, McPhee SJ, Rabow MW. ama-eds. Ukutholakala Kwezokwelapha Nokwelashwa Kwamanje 2015 . ENew York, NY: McGraw-Hill; 2014.
> I-Mosby's Drug Reference yezobuchwepheshe bezeMpilo, uMqulu wesibili. U-Elsevier ngo-2010.