Icyo Apixaban ari cyo: Ibikoreshwa, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Apixaban ni umuti wandikirwa na muganga ugabanya amaraso, ufasha kwirinda amaraso avura mu mubiri wawe. Uyu muti ubarirwa mu cyiciro gishya cy'imiti yitwa direct oral anticoagulants, ikora mu buryo butandukanye n'imiti ya kera igabanya amaraso nka warfarin. Muganga wawe ashobora kukwandikira apixaban niba ufite indwara zimwe na zimwe z'umutima cyangwa ukeneye kurengerwa n'amaraso avura ateza stroke.

Apixaban ni iki?

Apixaban ni umuti ugabanya amaraso ugabanya ubushobozi bw'amaraso yawe bwo kuvura. Utekereze nk'umurinzi ukomeza amaraso yawe atembera neza mu miyoboro yawe. Bitandukanye n'imiti imwe ya kera igabanya amaraso, apixaban ikora ibyo ikingira mu buryo butaziguye poroteyine yihariye ivuza amaraso yitwa Factor Xa mu maraso yawe.

Uyu muti uza mu buryo bw'ibinini kandi ufata mu kanwa kabiri ku munsi. Yagenewe gutanga uburinzi buhoraho umunsi wose hatagombye ibizamini by'amaraso bihoraho kugenzura ingaruka zayo. Uyu muti wigiweho cyane kandi byagaragaye ko ufite akamaro mu kwirinda ingorane zikomeye ziterwa n'amaraso avura.

Apixaban ikoreshwa mu iki?

Apixaban ivura indwara nyinshi aho amaraso avura ateza ibibazo bikomeye by'ubuzima. Muganga wawe arayikwandikira iyo inyungu zo kwirinda amaraso avura zirenze ibyago byo kuva amaraso. Uyu muti ufite akamaro cyane cyane ku bantu bafite ibibazo by'umutima cyangwa abakira ingorane zatewe n'amaraso avura.

Dore indwara nyamukuru apixaban ifasha kuvura, buri imwe ikaba isaba kugenzurwa na muganga witonze:

• Kugira umutima utagira umurongo (atrial fibrillation) - birinda ko amaraso avura mu mutima akaba yakwica
• Uburwayi bwo mu mitsi y'amaguru (DVT) - buvura amaraso avuye mu mitsi y'amaguru kandi bugakumira ko atagaruka
• Uburwayi bwo mu mitsi y'umutima - buvura amaraso avuye mu mitsi y'umutima
• Gukumira amaraso avura nyuma yo kubagwa - birinda abarwayi nyuma yo kubagwa mu kuguru cyangwa mu ivi
• Gukumira indwara yo mu mutwe ya kabiri - bigabanya ibyago byo kurwara indwara yo mu mutwe ku barwayi bamwe na bamwe

Buri kimwe muri ibi birwara bisaba imiti itandukanye n'uburyo bwo gukurikirana. Muganga wawe azagena uburyo bukwiye bushingiye ku buzima bwawe bwihariye.

Apixaban ikora ite?

Apixaban ikora ibuza Factor Xa, poroteyine y'ingenzi mu mikorere y'amaraso yawe. Iyo iyi poroteyine yabuze, amaraso yawe atinda kuvura, bigabanya ibyago byo guhagarika imitsi yawe. Ibi bituma apixaban iba umuti ukomeye wo gutuma amaraso atavura, utanga uburinzi bwizewe.

Uyu muti utangira gukora mu masaha make nyuma yo gufata urugero rwa mbere, ukagera ku gipimo cyiza mu masaha 3-4. Bitandukanye na warfarin, apixaban ntisaba umubiri wawe gusenya ibintu byari bisanzwe bivura amaraso, bityo itangira kukurinda vuba cyane. Amaraso yawe azasubira mu buryo busanzwe bwo kuvura amaraso mu masaha 24-48 nyuma yo guhagarika umuti.

Iki gikorwa cyihariye gituma apixaban iteganywa neza kurusha imiti isanzwe yo gutuma amaraso atavura. Ntabwo uzakenera ibizamini by'amaraso bya buri gihe kugirango urebe niba umuti ukora neza, nubwo muganga wawe azakomeza gukurikirana ubuzima bwawe muri rusange n'imikorere y'impyiko.

Nkwiriye gufata apixaban nte?

Fata apixaban nkuko byategetswe, akenshi kabiri ku munsi mu bihe bimwe na bimwe buri munsi. Urashobora kuyifata hamwe n'ibiryo cyangwa utabifite, nubwo kuyifata n'ibiryo bishobora kugabanya kuribwa mu gifu. Mimina ibinini byose n'amazi - ntukabice, ntukabice, cyangwa ngo ubisye.

Niba ugira ingorane zo kumira ibinini, urashobora kubisakuranga ukabivanga n'amazi, umutobe w'apulo, cyangwa apulososi. Koresha urwo ruvange ako kanya kandi ntukabike ngo uzarukoreshe nyuma. Abantu bamwe babona ko bifasha gufata apixaban hamwe na safuli na nimugoroba kugira ngo bashyireho gahunda ihamye.

Ntuzigere wongera doze yawe niba wibagiwe imwe, kandi ntukareke gufata apixaban ako kanya utabanje kuvugana na muganga wawe. Guhagarika ako kanya birashobora kongera ibyago byawe byo gukora ibibumbe by'amaraso, bishobora guteza akaga ku buzima bitewe n'uburwayi bwawe.

Nzagomba Kumara Igihe Kingana Gite Ndafatwa Apixaban?

Igihe cyo kuvurwa na apixaban giterwa rwose n'uburwayi bwawe bwihariye n'ibintu bigushyira mu kaga. Abantu bamwe barabukeneye mu mezi make, mu gihe abandi bashobora kubufata imyaka cyangwa ndetse ubuzima bwabo bwose. Muganga wawe azajya agenzura buri gihe niba ukikeneye uburinzi bw'umuti.

Kuburwayi nk'uburwayi bwo mu mitsi yimbitse cyangwa embolism yo mu muhogo, kuvurwa mubisanzwe bifata amezi 3-6 mbere na mbere. Niba ufite atrial fibrillation, birashoboka ko uzakenera kuvurwa igihe kirekire igihe ikibazo cy'umutima gikomeje. Abarwayi bavuwe mubisanzwe babifata mu byumweru 2-5 bitewe n'ubwoko bw'ubuvuzi bwabo n'imikorere yabo.

Umuvuzi wawe azatekereza ibintu nk'ibyago byawe byo kuva amaraso, imikorere y'impyiko, n'ubuzima muri rusange mugihe cyo gushyiraho igihe cyo kuvurwa. Inama zisanzwe zifasha kumenya neza ko urimo kubona uburinganire bukwiye bwo gukumira ibibumbe by'amaraso n'ibyago byo kuva amaraso.

Ni Ibihe Bikorwa Bigaragara Byo Kuva Apixaban?

Kimwe n'imiti yose ituma amaraso atavura, ibyago bya mbere bya apixaban ni ukongera kuva amaraso, nubwo ibibazo bikomeye byo kuva amaraso bidakunze kubaho. Abantu benshi bafata neza umuti, ariko ni ngombwa kumenya ibikorwa bisanzwe n'ibitari ibisanzwe. Muganga wawe yaguhaye apixaban kuko bemera ko inyungu ziruta ibyo byago bishobora kubaho.

Ibikorwa bisanzwe ushobora guhura nabyo birimo:

• Gukomeretswa byoroshye cyangwa ibikomere biza nta mpamvu igaragara
• Ukuva amaraso guto bifata igihe kirekire kugira ngo bihumbe (nk'aho biva mu gukata guto)
• Umuvumo w'amazuru ushobora kuba mwinshi cyangwa ukamara igihe kirekire
• Iminsi y'imihango iremereye ku bagore
• Urubavu ruto cyangwa isesemi
• Kuribwa umutwe cyangwa kumva ureremba

Ibi bintu bisanzwe bikunze gukira uko umubiri wawe ukimenyereza umuti kandi ntibisaba guhagarika imiti.

Ingaruka zikomeye zisaba ubufasha bwihuse bw'abaganga kandi zirimo:

• Ibimenyetso byo kuva amaraso menshi - kuruka amaraso, kwituma ibintu byirabura, cyangwa gukorora amaraso
• Kuribwa umutwe cyane, urujijo, cyangwa impinduka mu mbono (gushobora kuva amaraso mu bwonko)
• Umunaniro udasanzwe, uruhu rworoshye, cyangwa umutima utera vuba (ibimenyetso byo gutakaza amaraso menshi)
• Kuribwa mu ngingo no kubyimba (gushobora kuva amaraso mu ngingo)
• Kugorwa no guhumeka cyangwa kuribwa mu gituza

Nubwo izi ngaruka zikomeye zitamenyerewe, zisaba ubufasha bwihutirwa bw'abaganga nibibaye.

Ibintu bidasanzwe ariko bishobora kuba bikomeye birimo ibisubizo bya allergie hamwe n'uruhu ruruka, kubyimba mu maso cyangwa mu muhogo, no kugorwa no guhumeka. Abantu bamwe bashobora kugira ibibazo by'umwijima, nubwo ibi bidasanzwe cyane. Vugana n'umuganga wawe ako kanya niba ugize ibimenyetso bibangamiye.

Ninde utagomba gufata Apixaban?

Abantu bamwe bagomba kwirinda apixaban kubera ibyago byiyongereye by'ibibazo bikomeye. Muganga wawe asuzuma neza amateka yawe mbere yo gutegeka uyu muti. Niba ufite kimwe muri ibi bintu, apixaban ntishobora kuba itekanye kuri wewe.

Ntugomba gufata apixaban niba ufite:

• Kuva amaraso menshi cyangwa amateka y'indwara zikomeye zo kuva amaraso
• Indwara zikomeye z'impyiko zisaba dialysis
• Valves z'umutima z'ubukorano (valves za prosthetic za mekaniki)
• Allergie izwi kuri apixaban cyangwa imiti isa nayo
• Syndrome ya Antiphospholipid (indwara idasanzwe yo kwivumbura)

Ibi bintu byongera cyane ibyago byo kuva amaraso cyangwa bigatuma apixaban itagira akamaro mu kurinda.

Inama zindi zigomba gukurikizwa niba urwaye indwara yo hagati ya impyiko, ibibazo by'umwijima, cyangwa ufite imyaka irenga 80. Muganga wawe ashobora gukomeza kugutera apixaban ariko ashobora gukoresha urugero ruto kandi akagukurikiranira hafi. Gutwita no konsa nabyo bisaba kwitonderwa by'umwihariko, kuko amakuru yerekeye umutekano muri ibyo bihe ari make.

Amazina y'ubwoko bwa Apixaban

Apixaban ikunze kuboneka ku izina ry'ubwoko rya Eliquis muri Leta Zunze Ubumwe z'Amerika no mu bindi bihugu byinshi. Iri ni ryo zina ry'ubwoko ryambere ryakozwe na Bristol Myers Squibb na Pfizer. Umuti ushobora kugira amazina y'ubwoko atandukanye mu bihugu bitandukanye, ariko ikintu gikora kiguma kimwe.

Ubwoko bwa apixaban bwa generic burimo kuboneka mu turere tumwe na tumwe, bishobora gutwara amafaranga make kurusha ubwoko bw'izina. Niba wakira apixaban y'izina ry'ubwoko cyangwa generic, umuti ukora kimwe kandi utanga uburinzi bungana kuva amaraso.

Uburyo bwa Apixaban

Izindi miti myinshi ituma amaraso atavura ishobora gukora nk'uburyo bwa apixaban niba itagukwiriye. Muganga wawe ashobora gutekereza izi nzira ashingiye ku byo ukeneye mu buvuzi, imikorere y'impyiko, n'ibindi bintu. Buri nzira ifite inyungu zayo n'ibitekerezo.

Imiti ituma amaraso atavura isa na apixaban irimo:

• Rivaroxaban (Xarelto) - ifatwa rimwe ku munsi kubera ibintu byinshi
• Dabigatran (Pradaxa) - bisaba gukoreshwa kabiri ku munsi nka apixaban
• Edoxaban (Savaysa) - mubisanzwe ifatwa rimwe ku munsi

Iyi miti ikora kimwe na apixaban ariko ishobora kugira gahunda zitandukanye zo gukoresha cyangwa ibimenyetso by'uruhande.

Imiti gakondo ikoreshwa mu kuvura amaraso nk'iyo bita warfarin (Coumadin) iracyakoreshwa, cyane cyane ku bantu bafite uburwayi bw'imitsi y'umutima. Ariko, warfarin isaba gupima amaraso kenshi kandi igira ingaruka nyinshi ku biribwa n'imiti kurusha apixaban. Imiti iterwa mu nshinge nka enoxaparin (Lovenox) ishobora gukoreshwa mu gihe gito cyangwa igihe imiti yo kunywa itakwemerera.

Ese Apixaban iruta Warfarin?

Apixaban itanga inyungu nyinshi kurusha warfarin ku bantu benshi bakeneye imiti igabanya amaraso. Ubushakashatsi bwerekana ko apixaban ifite ubushobozi bungana na warfarin mu gukumira amaraso gupfunduka, hari n'ibimenyetso byerekana ko ishobora kuba nziza kurusha iyindi ku burwayi bumwe na bumwe. Guhitamo hagati yazo biterwa n'uburwayi bwawe bwihariye n'ibyo ukunda.

Inyungu zikomeye za apixaban zirimo kutagomba gupima amaraso buri gihe, ingaruka nkeya ku biribwa n'imiti, ndetse n'igipimo gito cyo kuva amaraso mu bwonko. Urashobora kurya imboga zifite amababi y'icyatsi kibisi kandi ukagira imibereho isanzwe utagombye guhangayika ku ngaruka z'imiti. Iyi miti itangira gukora vuba kandi ikava mu mubiri wawe vuba.

Ariko, warfarin iracyakoreshwa ku bantu bamwe, cyane cyane abafite imitsi y'umutima ikora mu buryo bwa mekaniki cyangwa bafite indwara zikomeye z'impyiko. Warfarin kandi ihendutse cyane kandi imaze imyaka myinshi ikoreshwa mu buryo butagira ingaruka. Niba uvira amaraso ukoresha apixaban, abaganga bafite uburambe bwo kuvura ibibazo byatewe na warfarin.

Umuvuzi wawe azatekereza ku bintu nk'imikorere y'impyiko zawe, indi miti ukoresha, imibereho yawe, n'ibyo ukunda mu guhitamo hagati y'izi miti.

Ibibazo Bikunze Kubazwa Kuri Apixaban

Ese Apixaban irakwiriye ku bantu barwaye indwara z'impyiko?

Apixaban ishobora gukoreshwa neza ku bantu barwaye indwara yoroheje cyangwa yo hagati y'impyiko, ariko bisaba guhindura urugero rwa imiti no gukurikiranwa neza. Muganga wawe azagenzura imikorere y'impyiko zawe mbere yo gutangira kuvurwa kandi buri gihe mu gihe urimo gufata umuti. Abantu barwaye indwara ikomeye y'impyiko isaba dialysis ntibagomba gufata apixaban.

Niba imikorere y'impyiko zawe yagabanutse ku rugero rwo hagati, muganga wawe ashobora gutegeka urugero ruto kugirango wirinde ko umuti wiyongera mu mubiri wawe. Iyi mpinduka irinda imikorere neza mugihe igabanya ibyago byo kuva amaraso. Igeragezwa ry'amaraso risanzwe rifasha kumenya niba impyiko zawe zigikora neza mugihe cyo kuvurwa.

Nigute nzakora niba mfashwe apixaban nyinshi bitunguranye?

Niba ufashwe apixaban nyinshi kuruta uko byategetswe, vugana na muganga wawe cyangwa ikigo gishinzwe kugenzura uburozi ako kanya, kabone niyo wumva umeze neza. Gufata nyinshi byongera ibyago byo kuva amaraso bikomeye, bishobora kutagaragara ako kanya. Ntukategere ibimenyetso byo kugaragara mbere yo gushaka ubufasha.

Mugihe utegereje inama ya muganga, reba ibimenyetso byo kuva amaraso nk'ibibazo bidasanzwe, amazuru ava amaraso, cyangwa amaraso mu nkari cyangwa mu musarani. Irinde ibikorwa bishobora gutera imvune, kandi ntufate izindi doze kugeza uvuganye n'umuganga. Mu bihe bikomeye, kuvurwa byihutirwa bishobora gukenerwa kugirango bikureho ingaruka z'umuti.

Nigute nzakora niba nirengagije doze ya apixaban?

Fata doze yawe yibagiranye ako kanya wibuka, ariko niba hashize amasaha atarenze 6 kuva igihe cyagenwe. Niba hashize amasaha arenga 6, reka doze yibagiranye hanyuma ufate doze yawe ikurikira ku gihe gisanzwe. Ntukigere ufata doze ebyiri icyarimwe kugirango usimbure doze yibagiranye.

Kutagira doze rimwe na rimwe ntibiba bikomeye, ariko gerageza kugumana gahunda ihamye kugirango wirinde neza. Tekereza gushyiraho alarme za terefone cyangwa gukoresha umuteguro w'ibinini kugirango wibuke doze zawe. Niba ukunda kwibagirwa doze, vugana na muganga wawe kubijyanye n'uburyo bwo kunoza imikoreshereze y'imiti.

Ryari nshobora kureka gufata Apixaban?

Ntuzigere uhagarika gufata apixaban ako kanya utabanje kubiganiraho na muganga wawe, kuko ibyo bishobora kongera cyane ibyago byo gukora amaraso. Muganga wawe azagena igihe bizaba byemewe guhagarika umuti bitewe n'uburwayi ufite n'ubuzima bwawe bw'ubu. Abantu bamwe bakeneye kuvurwa ubuzima bwabo bwose, mu gihe abandi bashobora kubihagarika nyuma y'igihe runaka.

Niba ukeneye guhagarika apixaban kubera kubagwa cyangwa izindi nzira z'ubuvuzi, muganga wawe azatanga amabwiriza yihariye yerekeye igihe. Bashobora kugusaba gukoresha imiti iterwa mu nshinge igihe gito cyangwa guhagarika gusa igihe gito bitewe n'ibyago byawe byo gukora amaraso n'inzira iri gukorwa.

Nshobora kunywa inzoga nkanwa apixaban?

Kunywa inzoga mu rugero ruciriritse muri rusange byemewe mugihe ufata apixaban, ariko kunywa cyane bishobora kongera ibyago byo kuva amaraso. Inzoga zirashobora kugira ingaruka ku bushobozi bw'umwijima bwo gutunganya umuti kandi bishobora gutuma ugwa cyangwa ukomereka. Ganira ku mikoreshereze yawe y'inzoga ukuri na muganga wawe kugirango umenye icyo gukora kuri wowe.

Niba uhisemo kunywa, wikwirakwiza ku kinyobwa kimwe ku munsi ku bagore cyangwa ibinyobwa bibiri ku munsi ku bagabo. Reba niba hari gukomeretsa cyangwa kuva amaraso nyuma yo kunywa, kandi wirinde kunywa inzoga nyinshi. Abantu bamwe basanga inzoga zibatera kuribwa umutwe cyangwa kutagira umutuzo, ibyo bishobora kongera ibyago byo gukomereka mugihe ufata imiti ituma amaraso ativura.