Dokokin NOAC - maye gurbin na Coumadin
Idan kayi kallon duk wani TV, to, kuna ganin tallace-tallace don sababbin kwayoyin halitta wanda ake kira Pradaxa, Eliquis, Xarelto, da kuma Savaysa. Kasuwanci suna da'awar cewa wadannan kwayoyi sun fi sauƙin ɗauka, sun fi aminci, kuma suna da tasiri (idan ba su fi tasiri) fiye da Coumadin (warfarin) ba.
Yayinda wadannan ikirarin ba su da kyau, ba su gaya mana labarin ba.
Matsaloli tare da Mutum
Ga marasa lafiya waɗanda suke buƙatar ɗaukar kwayoyi masu tayar da hankali (alal misali, mutanen da ke da magungunan ƙwayar cuta , mai zurfi mai haɗari , ko haɗin jini ), shekaru masu yawa shine kawai tasiri mai kyau shine Coumadin.
Yin amfani da Coumadin a amince da yadda zai iya zama babban kalubale. Ya zama wajibi ne don samun gwaje-gwaje na jini don auna ma'auni na coagulation (jini "jini"), kuma sau da yawa ana gyara daidaitawa ana buƙatar kiyaye matsayi na coagulation a cikin kewayon daidai. Canje-canje a cikin lafiyar, har ma cin abincin mara kyau, zai iya yin jini "ma bakin ciki" (wanda zai iya ƙara haɗarin jini mai tsanani), ko kuma "bakin ciki" (wanda zai iya ƙara haɗarin jini). A mafi kyau, shan Coumadin ba shi da wata damuwa.
Magunguna da aka nuna a cikin waɗannan tallace-tallace sun fito ne daga sababbin magungunan kwayoyi wanda, a cikin masu yawa marasa lafiya, suna ba da wata madaidaici ga Coumadin. Doctors sau da yawa suna magana ne akan wadannan kwayoyi kamar yadda NOACs - "litattafan magungunan magunguna."
Yaya Ayyukan NOACs
Magungunan anticoagulant suna aiki ne ta hanyar hana haɓakar coagulation (wanda ake kira abubuwan gurgunta) cikin jini. Hanyoyi masu rarrafe sune jerin sunadarin sunadarai da ke aiki tare da jini don samar da jini.
Hussaini yana aiki ne ta hanyar hana bitamin K, bitamin da ake buƙata domin kira da yawa akan yin amfani da kwayoyin halitta.
A gaskiya ma, samar da bitamin K shine hanya mai mahimmanci don sauke da sakamako na Coumadin.
Ayyuka na NOAC ta hanyar kai tsaye don hana wasu takaddama. Pradaxa (dabigatran) kai tsaye ya hana thrombin, wanda ake kira clotting factor IIa.
Sauran samuwa NOACs - Xarelto (rivaroxaban), Eliquis (apixaban), da Savaysa (edoxaban) - aiki ta hanyar hana wani abu daban daban na clotting, factor Xa.
Mene ne yake sanya 'yan kungiyar NOAC "Better" Than Coumadin?
Aikin na NOAC suna da babbar amfani a kan Coumadin. Hakanan, sun samar da sakamako mai tsauraran maganganu tare da daidaitattun jituwa, don haka ba za a gwada gwaje-gwajen jini ba ko ana bukatar gyarawa. Kuma babu wani hani na rage cin abinci da ke hade da shan NOACs. Sabili da haka, daukar nauyin na NOAC suna da tsauri don raunana rayuwar mutum fiye da shan Coumadin.
Bugu da ƙari kuma, binciken na asibiti ya bayar da shawarar cewa CASA suna da tasiri a matsayin Coumadin don hana yaduwar jini. Kuma hadarin babban rikitarwa na jini tare da NOACS ya nuna ba wanda ya fi girma tare da Coumadin (kuma yana iya zama ƙasa).
Mene Ne Abubuwan Tambaya Ga NOACs?
Zai yiwu babban hasara shi ne cewa, da bambanci da Coumadin, babu maganin maganin maganin maganin maganin maganin maganin maganin maganin cutar.
Wannan yana nufin cewa idan babban zubar da jini yana faruwa, yiwuwar mummunan sakamako zai iya zama mafi girma fiye da Coumadin.
A watan Oktobar, 2015, FDA ta amince da sababbin sababbin maganin Praxbind (ƙirar) don sake farfado da sakamakon Pradaxa. Samun maganin maganin Pradaxa muhimmin ci gaba ne.
Duk da haka, tun da sauran magunguna na NOAC sun hana factor Xa, kuma ba matsala ba kamar Pradaxa, Praxbind ba zai sake farfado da su ba. Ana nuna alamar maƙallan Xa.
Pradaza da Eliquis suna buƙatar sau biyu a rana dosing, ba kamar Xarelto da Savaysa (da Coumadin) wanda kawai za a dauka sau ɗaya a rana ba.
Ƙungiyoyin na NOAC sun fi tsada fiye da Coumadin, kuma kudin zai iya hanawa ga mutanen da inshora ba su rufe su.
Ba a amince da Ƙungiyar CAC ba don wasu amfani, alal misali, a cikin marasa lafiya da kwakwalwa na wucin gadi ko masu ciki.
Wadannan kwayoyi sunfi kisa da kodan, kuma suna buƙatar amfani da su sosai, idan koda yake, a marasa lafiya da cutar koda.
A ƙarshe, tun da cewa NOACs sun kasance mawuyacin ƙwayoyi, yana yiwuwa ƙarin, halin da ba a sani ba a yanzu ba zai iya bayyana ba. (Wannan lamari ne mai daukan gaske, ba shakka, tare da sababbin ƙwayoyi.)
Yaya aka yi amfani da CASA?
Gaskiya, wannan tambaya ce da masana masana kiwon lafiya ke yanzu suna rarrabawa. Amma saboda sanannun da aka sani na Coumadin, yawancin masana suna jingina da karfi wajen bada shawarar sababbin kwayoyi masu amfani da kwayoyin halitta kamar yadda na farko a cikin mutane da yawa waɗanda suke buƙatar maganin kututtuka na yau da kullum.
Kalma Daga
Kwayoyin na NOAC suna ba da wata hanya madaidaiciya ga mutanen da suke buƙatar ciwon maganin rigakafi, kuma ga mutane da yawa, sune wani zaɓi mai kyau.
Wasu mutane zasu iya samun likitocin su suna nuna sabon sabbin kwayoyi idan an fara farautar su a karo na farko, idan sun kasance da wuya a ci gaba da kasancewa cikin kwanciyar hankali na Coumadin, ko kuma idan (bayan sauraron yiwuwar hadarin da wadata na duk zaɓuɓɓuka) da kansu suna bayyana fifiko mai kyau ga sababbin magunguna. A gefe guda, mutanen da suke shan Coumadin sun samu nasarar - tare da gwajin jini a kan kwaskwarima - don 'yan watanni ko ya fi tsayi su ne mafi alhẽri daga yin jima'i tare da Coumadin.
> Sources:
> Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran Versus Warfarin a cikin marasa lafiya tare da Atrial Fibrillation. N Engl J Med 2009; 361: 1139.
> Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban zuwa Warfarin A cikin Invalvular Atrial Fibrillation. N Engl J Med 2011; 365: 883.
> Granger CB, Alexander JH, McMurray JJ, et al. Apixaban zuwa warfarin a cikin marasa lafiya tare da Atrial Fibrillation. N Engl J Med 2011; 365: 981.
> Furie KL, Goldstein LB, Albers GW, et al. Maganin Antithrombotic Maganganu don Rigakafin Harkokin Rigakawa a Cikin Gudanar da Ƙwararriyar Aikin Ƙarshe: Shawarar Kimiyyar Kimiyya ga Ma'aikatan Kula da Lafiya daga Ƙungiyar Zuciya ta Amirka / Ƙungiyar Harkokin Cutar Amirka. Tashi 2012.