Nemo ma'anar "Mafi kyawun" Jigilar Magunguna don Kai
Jerin magungunan kwayoyi da magungunan miyagun ƙwayoyi da aka fi amfani dasu don magance hauhawar jini (cutar hawan jini) yana da dadewa.
Gaskiyar cewa akwai kwayoyi masu yawa don zaɓar daga wajen akalla abu biyu. Na farko, yana nufin babu wani "magani mafi kyau" don hauhawar jini, wato, babu magani wanda ke aiki sosai a kusan kowa da kowa ba tare da haifar da mummunar tasiri ba.
Idan akwai, kamfanonin miyagun ƙwayoyi sun dakatar da kokarin su na inganta sababbin magungunan antihypertensive da suka wuce-da kuma jerin samfurin da aka yarda da shi zai kasance ya fi guntu.
Na biyu, tare da yawancin kwayoyi don zaɓar daga, idan dai kai da likitanka sunyi hakuri da kuma ci gaba, to akwai yiwuwar samun tsarin kulawa mai mahimmanci da jurewa don jinin ka. A wasu kalmomi, yayinda babu magani "mafi kyau" na duniya don hauhawar jini, akwai yiwuwar zama "mafi kyau" magani a gare ku.
A cikin wannan labarin, zamu bayyana irin kwayoyi da ake amfani dashi don hawan jini, da kuma abin da likitanku ya kamata ya dauka a zabar (daga cikin tsararren zaɓuɓɓuka) da kyakkyawan magani. A ƙarshe, zamu samar da jerin cikakkun jerin dukkanin kwayoyi da ake amfani dasu yanzu a Amurka (da kuma a yawancin ƙasashe masu tasowa) don maganin hauhawar jini.
Zaɓin Tsarin Dama don Tsawan jini
Doctors kullum suna amfani da tsarin kulawa na musamman don zaɓar mafi kyau duka farfadowa don hauhawar jini.
Mataki na 1: Ga mutanen da aka gano tare da hawan jini mai sauƙi ko matsakaici , yana da muhimmanci a fara da bada shawarar canje-canje na rayuwa wanda aka nuna don taimakawa rage karfin jini. Wadannan sun hada da canje-canje masu cin abinci , ƙuntata gishiri , motsa jiki na yau da kullum, da kuma shan taba shan taba.
Mataki na 2: Idan waɗannan matakan salon rayuwa ba su haifar da isasshen tsaftacin jini ba bayan da yawa makonni, yawanci shine lokaci don ƙara magani.
Hanyar Bincike don Zaɓin Harkokin Drug don Tsawan jini
Akwai ƙananan magungunan ƙwayoyi guda biyar waɗanda aka tabbatar da ingancin maganin hauhawar jini. Wadannan su ne:
- Thurezide diuretics
- Angiotensin musanya enzyme (ACE) inhibitors
- Kwayoyin kwalliya
- Beta blockers
- Angiotensin masu karɓan sakon masu karba (ARBs)
Maganin Drug ne kawai
Idan kana da mataki na 1 hauhawar jini (inda kullin komolic dinka ya kai 160 mm Hg, kuma matsa lamba na diastolic ya kasa da 100 mm Hg), shawarwarin gaba shine farawa da miyagun ƙwayoyi ɗaya daga cikin waɗannan nau'o'i biyar.
Bugu da ƙari, kwayoyi daga kowane ɗayan ɗalibai (banda beta-blockers, wadanda basu da mahimmanci a matsayin kwayoyi masu magungunan) sunyi aiki sosai a cikin sarrafa hauhawar jini. Musamman, akwai kimanin 50-50 cewa kowane magani zai yi aiki daidai a kowane mutumin da aka ba da mataki na 1 hauhawar jini.
Duk da haka, mutane zasu amsa daidai da waɗannan magunguna. Jim zai iya amsawa da kyau sosai ga wani abu, amma yayi rashin lafiya tare da mai ɗauka mai kwakwalwa, kuma batun tare da Jane iya zama ainihin baya. Babu wata hanyar da za ta iya hango ko wane mutum zaiyi kyau da irin magani. Don haka, abin da likitocin da marasa lafiya suka bari tare da ita shine tsarin ilimin gwaji da kuskure.
A cikin "ganewa" a kan mafi kyawun maganin miyagun ƙwayoyi guda ɗaya don gwada, yawancin masana sun bayar da shawarar farawa ko dai dai ko dai wani thurezide diuretic (yawanci chlorthalidone ko hydrochlorothiazide), mai hana mai kwakwalwa mai tsawon lokaci, ko mai hanawa mai kula da ACE. Ana zaton dukkanin ARBs a matsayin masu maye gurbin ACE masu hanawa, kuma ana amfani da su ne kawai a lokacin da aka hana masu hana ta ACE.
Babu ka'idoji masu sauri da sauri game da abin da kwayoyi zasu yi amfani da su, amma akwai wasu dabi'u waɗanda suke da amfani wajen zabar maganin miyagun kwayoyi:
- Ƙananan marasa lafiya yawanci suna amsawa ga masu hana ACE.
- Black marasa lafiya da kuma tsofaffi marasa lafiya ayan yi mafi alhẽri tare da thiazide diuretics ko calcium tashar blockers.
- Marasa lafiya marasa lafiya suna yin rashin talauci tare da masu hanawa ACE.
- Beta blockers yawanci a matsayin maras kyau matsala ga magani guda daya magani, kuma ana amfani da su kawai idan akwai wani dalili na kiwon lafiya don amfani da beta blockers (kamar bukatar su bi da angina ko zuciya zuciya , ko don sarrafa zuciya a cikin wani mutum tare da filastillation ).
Bugu da ƙari, ƙwayar cutar maganin jini yana da tasiri kamar yadda yafi tsayi, kuma yana haifar da ƙananan sakamako. Don haka, lokacin da kake ƙoƙarin samun maganin ƙwayoyi guda ɗaya, likitoci sukan fara da kashi kadan. Za su iya yanke shawara don ƙara yawan kashi idan bitar farko ba ta da amfani - amma yana da wuya amfani da "tura" kashi na maganin miyagun ƙwayoyi guda ɗaya a cikin jeri mafi mahimmanci. Maimakon haka, idan miyagun ƙwayoyi ba zai aiki a wani ƙananan ƙananan kashi ba, lokaci ya yi da za a canja zuwa kashi kadan na magungunan daban.
Ta amfani da irin wannan kuskuren kuskuren da kuskure, kimanin kashi 80 cikin dari na mutanen da ke da matsin lamba 1 za a iya magance su da kyau tare da miyagun ƙwayar cuta ɗaya.
Haɗin Drug Far
Yin amfani da magungunan fiye da ɗaya don bi da hauhawar jini ya zama dole a ƙarƙashin yanayi biyu. Da farko, ana amfani da farfadowa a cikin mutanen da ke da matakan hawan jini 1 kuma a kalla an yi ƙoƙari guda biyu ko uku don magance cutar hawan jini tare da maganin miyagun kwayoyi.
Na biyu, ana amfani da magungunan maganin miyagun ƙwayoyi a cikin mutane waɗanda ke da matsayi na 2 (wato, matsa lamba ta systolic shine 160 mm Hg ko mafi girma, ko matsa lamba na diastolic 100 mm Hg ko mafi girma.) Magungunan maganin miyagun ƙwayoyi yana da wuya a yi aiki a cikin waɗannan mutane , don haka haɗin haɗin suna yawanci zaba daga farkon.
Tare da yawancin kwayoyi don zaɓar daga, ta yaya likitoci zasu iya yanke shawarar wane kwayoyi zasu hada? Abin godiya, an gudanar da gwaje-gwaje da yawa a cikin gwaji don bayar da shawarwari mai kyau wajen zabar maganin haɗakar haɗari.
Mafi kyawun shaida (daga jarrabawar KASHI) yana nuna cewa sakamakon ciwon asibiti (ciki har da haɗarin bugun jini , ciwon zuciya da kuma cututtukan zuciya) ana inganta su tare da hadewa yayin da ake amfani da caca mai kwakwalwa mai tsawo tare da mai hana ACE ko ARB. Saboda haka, a yau yawancin likitoci zasu gwada wannan hade.
Idan cutar hawan jini ya kasance da haɓaka tare da hadewa ta hanyar amfani da mai kwakwalwa mai ƙwayar cuta tare da maganin ACE ko ARB, za a kara yawan maganin miyagun ƙwayoyi a matsayi na uku. Kuma idan har yanzu wannan haɗin ke kasa kula da karfin jini, za'a iya kara magunguna na hudu (yawanci spironolactone, mai ba da thiazide diuretic).
Mafi yawan marasa lafiya tare da hauhawar jini za su cimma nasarar farfadowa kafin a yi la'akari da kashi uku ko na hudu. Mutumin da ya kasa amsawa da kyau ga wannan nau'in hadewa ya kamata a kira shi a matsayin likita na hauhawar jini.
Guje wa Hanyoyin Cutar Daga Harkokin Kwayoyin Harkokin Harkokin Tsaro
Duk wani magungunan da ake amfani da su don maganin hauhawar jini yana da yiwuwar haifar da matsaloli. Kuma lokacin zabar tsarin "mafi kyawun" maganin miyagun ƙwayoyi don maganin mutumin da ke dauke da hawan jini, yana da mahimmanci don samun magani (ko kwayoyi) wanda ba wai kawai ya rage karfin jini ba, amma hakan ma ya dace.
Saboda wannan dalili, yana taimakawa sosai wajen yin amfani da ƙananan kwayoyin cutar hawan jini kamar yadda yake amfani da ƙwayoyin da suka fi girma. Samun yin samuwa tare da ƙananan sashi yana rage yawan haɗarin tasiri.
Duk da haka, waɗannan kwayoyi zasu iya haifar da matsalolin, kuma yana da mahimmanci a gare ka ka san abubuwan da zasu iya tasiri. Duk da yake kowace magungunan kwayar cutar kankara tana da nasaccen "tasirin tasiri," saboda mafi yawan abubuwan da kwayoyin magungunan suka haifar da alaka da su. Babban magunguna masu dangantaka da lalacewa sune:
- Thurezide diuretics: hypokalemia (matsanancin matakan potassium), urination sau da yawa, worsening na gout
- ACE masu hanawa: tari, asarar tsinkayen dandano, hyperkalemia (matakan da aka haɓaka da su)
- Kwayoyin calcium: ƙarfin zuciya, kumburi na kafafu, ciwon kai
- Beta blockers: damuwa da dyspnea a cikin mutane da ciwon da kullum obstructive cuta ko ciwon sukari , dysfunction, gajiya, ciki, damuwa da bayyanar cututtuka a cikin mutanen da ke dauke da cututtuka na jijiyoyin jini
- ARBs: rashin lafiyan halayen, dizziness , hyperkalemia
Tare da yawancin kwayoyi don zaɓar daga, yana da wuya cewa likita zai tambayi mutumin da ke dauke da hauhawar jini don jure wa abubuwa masu tasiri. idan ana kula da ku saboda hauhawar jini kuma kuna fuskantar duk wani tasiri mai tasiri, ya kamata ku yi magana da likitanku game da gano tsarin kulawa da za ku iya jurewa mafi alhẽri.
Jerin Jirgin Kwayoyin Tsawan jini na Mafi Girma
Kamar yadda muka gani a farkon wannan labarin, jerin kwayoyin da aka yarda don maganin hauhawar jini sunyi tsawo. A nan ne ƙayyadaddun jerin sunayen wadannan kwayoyi. Sunan sunayen kowane magungunan miyagun ƙwayoyi aka lissafa su na farko, sannan sunaye sunaye.
Diuretics
Diuretics ("kwayoyin kwayoyi") ƙara yawan sodium da ruwa da suka shiga cikin fitsari ta kodan. Ana tsammanin cewa sun rage yawan karfin jini ta hanyar rage karfin ruwa a cikin jini.
Diuretics da aka saba amfani dasu don hauhawar jini:
- Acetazolamide - Diamox
- Chlorthalidone - Thalidone, wanda aka sayar a matsayin Tenoretic da Clorpres
- Hydrochlorothiazide - HydroDiuril, wanda aka sayar a matsayin Microzide da Esidrix
- Farawa - Lozol
- Metolazone - Zaroxolyn, kuma aka sayar a matsayin Mykrox
Diuretics kasa da amfani dashi ga hauhawar jini:
- Amiloride hydrochloride - Midamor
- Bumetanide - Bumex
- Ethacrynic acid - Edecrin
- Furosemide - Lasix
- Spironolactone - Aldactone
- Torsemide - Demadex
- Triamterene - Dyrenium
Beta-blockers
Beta blockers sun kayar da sakamakon adrenaline a kan tsarin kwakwalwa, rage jinkirin zuciya, kuma rage danniya a zuciya da arteries.
- Acebutolol - Sectral
- Atenolol - Tenormin
- Betaxolol - Kerlone
- Bisoprolol - Zebeta, wanda aka sayar da shi a Ziac
- Mapolol - Cigaba
- Carvedilol - Coreg
- Labetalol - Normodyne, wanda aka sayar a matsayin Trandate
- Metoprolol - Lopressor, kuma aka sayar a matsayin Toprol
- Nadolol - Corgard
- Penbutolol - Levatol
- Propranolol - Indiya, Indiya LA
- Timolol - Blocadren
Ƙididdigar Lissafi na Calcium
Kwayoyin sashin launi na ƙwayoyin calcium na iya rage karfin jini ta hanyar dilating arteries kuma, a wasu lokuta, rage girman kullun zuciya.
- Amlodipine - Norvasc, kuma an sayar da su kamar Caduet da Lotrel
- Diltiazem - Cardizem, kuma aka sayar a matsayin Dilacor da Tiazac
- Felodipine - Plendil
- Isradipine - DynaCirc
- Nicardipine - Cardene
- Bisedipine - Procardia XL, kuma aka sayar a matsayin Adalat
- Nisoldipine - Sular
- Verapamil hydrochloride - Isoptin, wanda aka sayar kamar Calan, Verelan, da Covera
Angiotensin Converting Enzyme Inhibitors
Hanyoyin angiotensin masu musayar enzyme (masu "ACE masu hanawa") zasu iya rage karfin jini ta hanyar dilating arteries.
- Benazepril - Lotensin
- Captopril - Capoten
- Enalapril - Vasotec, wanda aka sayar a matsayin Vaseretic
- Fosinopril - Monopril
- Lisinopril - Prinivil, kuma aka sayar a matsayin Zestril
- Moexipril - Univasc
- Quinapril - Accupril
- Ramipril - Altace
- Trandolapril - Mavik
Angiotensin II Receptor Blockers
Hakanan masu satar kwayoyin angiotensin II ("ARBs") sun rage rage karfin jini ta hanyar dilating arteries.
- Candesartan - Atacand
- Irbesartan - Avapro
- Losartan - Cozaar
- Telmisartan - Micardis
- Valsartan - Diovan
Sauran, Kwayoyin Kwayoyin Hutad da Hannun Kwayoyin Kwayoyin Aiki
- Clonidine - Catapres
- Doxazosin - Cardura
- Guanabenz - Wytensin
- Guanfacine - Tenex
- Hydralazine hydrochloride - Apresoline
- Methyldopa - Aldomet
- Prazosin - Minipress
- Reserpine-ÂÂ Serpasil
- Terazosin - Hytrin
Hanyoyin maganin kwayoyi don hawan jini
An sayar da kwayoyi masu yawa don hawan jini, kuma yana da wuya a lura da sababbin sababbin waɗanda suka zo tare, ko kuma tsofaffi wadanda suka mutu. Wadannan su ne jerin cikakkun jerin sunayen ƙwayoyi masu haɗuwa da aka saba amfani da su don amfani da hawan jini.
- Amiloride da hydrochlorothiazide - Moduretic
- Amlodipine da benazepril - Lotrel
- Atenolol da chlorthalidone - Tenoretic
- Benazepril da hydrochlorothiazide - Lotensin HCT
- Bisoprolol da hydrochlorothiazide - Ziac
- Captopril da hydrochlorothiazide - Capozide
- Enalapril da hydrochlorothiazide - Vaseretic
- Felodipine da enalapril - Lexxel
- Hydralazine da hydrochlorothiazide - Apresazide
- Lisinopril da hydrochlorothiazide - Prinzide, kuma sun sayar da su azaman Zestoretic
- Losartan da hydrochlorothiazide - Hyzaar
- Methyldopa da hydrochlorothiazide - Aldoril
- Metoprolol da hydrochlorothiazide - Lopressor HCT
- Nadolol da bendroflumethiazide - Corzide
- Propranolol da hydrochlorothiazide - Inderide
- Spironolactone da hydrochlorothiazide - Aldactazide
- Triamterene da hydrochlorothiazide - Dyazide, kuma sun sayar da Maxide
- Verapamil kara saki) da trandolapril - Tarka
Kalma Daga
Rashin hawan jini shine matsalar lafiya ta musamman wanda zai iya haifar da mummunan sakamako idan ba'a kula da shi ba. Duk da haka, tare da yawancin zaɓuɓɓukan magani, ya kamata ka sa ran likitanka ya sami tsari na warkewa wanda zai rage yawan hadarin da mummunar sakamako daga hauhawar jini, ba tare da lalata rayuwar yau da kullum ba.
> Sources:
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> Jamerson KA, Bakris GL, Wun CC, et al. Rational da kuma zane na kaucewa abubuwan da ke faruwa a cikin kwaskwarima ta hanyar haɗuwa da juna a cikin marasa lafiya da ke dauke da hauhawar jini na jiki (ƙaddara) gwaji: ƙaddamarwa ta farko da aka sarrafa ta hanyar daidaitawa don kwatanta sakamako na asibiti sakamakon farfadowa na farko na jigilar jini a cikin hawan jini. Am J Hypertens 2004; 17: 793.
> Mancia G, Fagard R, Narkiewicz K, et al. 2013 Jagoran Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Kasuwanci na Harkokin Harkokin Harkokin Tsaro na Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Kasuwanci (ESH) da na Ƙungiyar Harkokin Kwayoyin Nahiyar Turai (ESC). J Hypertens 2013; 31: 1281.
> Weber MA, Schiffrin EL, White WB, et al. Ka'idojin Harkokin Gudanar da Harkokin Clinical don Gudanar da Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin Harkokin {ananan Jama'a ne, na {ungiyar Harkokin Harkokin Tsaro na {asar Amirka, da {ungiyar Harkokin Tsaro ta Duniya J Hypertens 2014; 32: 3.