Kwezinye, i-ACE inhibitors njenge-lisinopril ibangela ukukhwehlela nokuvuvukala.
I-Angiotensin-ukuguqula i-enzyme inhibitors (i-ACE inhibitors) njenge-lisinopril, i-captopril kunye ne-enalapril yimishanguzo yokulwa ne-antihypertensive. I-ACE inhibitors isebenzayo ekunciphiseni uxinzelelo lwegazi kwaye kaninzi ikhethwa kwezinye iindlela ezifana ne-beta-blockers (cinga propanolol). Nangona kunjalo, abanye abantu abakwi-ACE inhibitors bavelisa ukukhwehlela okomileyo okanye okwenyukayo-ukuphendulela-uhlobo oluthile lomzimba, umlomo nolwimi (i-angioedema) eyenza ukuthatha la mayeza anzima okanye abulawe.
Ziziphi ii-ACE Inhibitors?
I-ACE inhibitors ivimbela i-enzyme engaguqukiyo ye-angiotensin eguqula i-angiotensin I-angiotensin II. Ngokuthintela eli nyathelo elifunekayo kwinkqubo ye- renin-angiotensin , i-ACE inhibitors iyakwazi ukunciphisa uxinzelelo lwegazi nge-vasoconstriction kunye nokukhubazeka komsebenzi we-aldosterone.
I-Aldosterone iyi-hormone ye-steroid (i-mineralocorticoid) eveliswe yi-grenalthosa (zona glomerulosa), ehlala phezu kweentso zakho. I-Aldosterone ilawula ukuhlanjululwa komchamo ngeephrononi zeentso. Ngokukodwa, i-aldosterone isebenza ukuzisa i-sodium namanzi kwindawo yakho yokutshintshaniswa ngokutshintshela i-potassium ekhutshwe kwaye ikhutshwe. Ingqalelo, njengoko ichazwe yimithetho ye-osmosis, igcinwe i-sodium kunye namanzi kwandisa uxinzelelo lwegazi.
Nazi ezinye izibonelo ze-ACE inhibitors:
- lisinopril
- captopril
- perindopril
- enalapril
- benazepril
- fosinopril
I-ACE inhibitors ezifana ne-lisinopril zisetyenziselwa ukunyanga ingozi yomshukela ophezulu okanye uxinzelelo lwegazi oluphezulu kwaye zisebenza ngempumelelo kulabo bantu abanesifo esingasasigxina nesifo senhliziyo.
I-ACE inhibitors nayo isetyenziselwa unyango lwe-stroke, ukuhlaselwa yintliziyo, ukungaphumeleli kwentliziyo kunye nokuthintela iziganeko zentliziyo yengomso. Kufuneka kuqatshelwe ukuba ngokubanzi, i-ACE inhibitors-njengamanye amayeza anesifo esiphezulu-ayisebenzisekanga kangako ekunciphiseni uxinzelelo lwegazi nokukhusela ukuqhutyelwa kwesifo kunye nokuhlaselwa intliziyo kuma-Afrika aseMerika.
Ngokona nxalenye, i-ACE inhibitors ikhuselekile kwaye ibekezeleke kakuhle. Ukuba uthathe ngokungaphezulu, kunjalo, i-ACE inhibitors ibangela ukungaxilongo okanye ingcinezelo engaphantsi kwegazi kwaye unciphise intliziyo yakho (bradycardia), nayo. Xa umntu eba nexinzelelo oluphantsi kakhulu lwegazi kwi-ACE inhibitors, i-ACE inhibitor iyanqanyulwa kwaye i-waterproof ishicilelwe ukuzisa iingcinezelo. (Abacudisi abaqhelekanga ukuba baphinde baphinde bavuselele uxinzelelo lwegazi.)
Kulabo abaneempembelelo ezingenakukhubazeka okanye kwabo bathatha ii-NSAID (iziyobisi ezinjenge-aspirin), i-ACE inhibitors ingadibanisa amanqanaba omzimba wakho osiza obangela ama- hyperkalemia okanye amanqanaba angaphezulu kwe-potassium . I-Hyperkalemia imbi kuba iphazamisa intliziyo yakho kwaye iyakubulala. Emva kokuyeka ukukhawuleza kwe-ACE inhibitor, loo hyperkalemia iyaphathwa esibhedlele isebenzisa iziyobisi ezifana ne-calcium, i-insulin kunye ne-glucose njalonjalo.
I-ACE Inhibitors, i-Angioedema, neCough
Kwiimeko eziqhelekileyo, i-enzyme yokuguqula i-angiotensin idiliza i-bradykinin, umlamli ovuthayo ocinga ukuba ngumbangela wokukhwehlela owomileyo nokuvuvukala kubonwe malunga nama-25 ekhulwini abo bathatha i-lisinopli kunye nezinye i-ACE inhibitors. Ukuphendula okunjalo kubanzi kakhulu kubantu base-Afrika baseMerika
Kulabo bahlakulela i-angioedema, i-reaction-type-response reaction, i-ACE inhibitor ikhutshwa ngokukhawuleza kwaye i-steroids kunye ne-diphenhydramine (uBenadryl) inikwe ukulawula ukuvuvukala. Ukuzikhukhumeza okunjalo kunokuba yimeko engxamisekileyo yonyango kuba inokubangela ukuhamba kwendlela yakho kwaye ingaba naliphi na ixesha ngelixa i-ACE inhibitors. Ngamanye amagama, ungathatha i-ACE inhibitors ixesha elithile ngaphambi kokuba ufumane i-angioedema.
Ukukhwehlela okubangelwa yi-ACE inhibitors akufuneki unyango ngaphandle kokuyeka ukusetyenziswa kweziyobisi. I-ACE inhibitors inobomi obufutshane kakhulu kunye nomthamo ophantsi wokusabalalisa kwaye kufuneka uhlambe ngaphandle kwakho emini.
Ukuba wena okanye othandekayo uthatha i-ACE inhibitor njenge-lisinopril kwaye ufumana ukukhwehlela, nceda yenza ixesha lokubona ugqirha wakho ukuvavanya. Ugqirha wakho uya kushiya i-ACE inhibitor kwaye aqalise kwenye iyeza ezichasayo ezinjenge-ARB (i-angiotensin II receptor blocker).
Ukuba wena okanye umntu othandayo unama-angioedema kunye nokuguga kokuphila esongela ubomi ngexesha le-ACE inhibitor, musa ukuthabatha amanye amayeza kwaye wuleze u-911. Emva kokunyanga nge-steroids kunye ne-Benadryl, ugqirha wakho unokukuhlalutya kwaye akunike esinye isilingo somfutho wegazi ophezulu . Nceda uqaphele ukuba le nkunkuma mhlawumbi ayiyi kuba yi-ARB kuba ii-ARB ziyaziwa ukuba zikho nto zingabangela ukuba i-angioedema, nayo.
Kwiphepha lokugqibela, ezinye iimpendulo ezingathandekiyo ezichaphazelekayo kwi-ACE inhibitors njengengcinezelo yecala engaphantsi kwegazi kunye nokuxutywa kwegazi (hyperkalemia) ngokuqhelekileyo kubangelwa ukugqithisa ngokweqile, imithi (i-NSAID) okanye umsebenzi onobungozi obuthathaka obuguqula isigunyaziso. Ngaloo ndlela, ngelixa uthabatha i-ACE inhibitors, qiniseka ukuba ubeka iliso rhoqo uxinzelelo lwegazi lwakho, ulandele ugqirha wakho kwaye uqhagamshelane nodokotela wakho ukuba uziva unesihlunu, unesihloko esikhanyayo, u-dizzy okanye njalo.
Imithombo
Atkins G, Rahman M, Wright JT, Jr. Isahluko 70. Ukuxilongwa nokuPhathwa kwe-Hypertension. Ku: I-Fuster V, i-Walsh RA, i-Harrington RA. eds. I-Heart's Heart, 13e . New York, NY: McGraw-Hill; Ngo-2011. Ukufikeleleka ngo-Ephreli 18, 2015.
Hayashi SA. Isahluko 10. I-Angiotensin Blockers kunye ne-ACE Inhibitors. Ku: Olson KR. eds. Ukutyhefuza nokugqithiswa kweDrug, 6e . New York, NY: McGraw-Hill; 2012. Kufumaneka ngo-Ephreli 18, 2015.